TATYANA PETROSOVA, MD PC – Nephrology Physician, NPI 1700026515
Nephrology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for TATYANA PETROSOVA, MD PC
936 Charbonier Rd
FLORISSANT, MO 630315220
Phone: (314) 797-7074
Fax: (314) 227-5505
Type: Location
10 Hospital Dr Fl 3
Saint Peters, MO 633761659
Phone: (636) 317-4000
Fax: (314) 227-5505
Type: Location
330 1st Capitol Dr Ste 240
Saint Charles, MO 633012846
Phone: (636) 443-2440
Fax: (314) 227-5505
Type: Location
1021 Wentzville Pkwy
Wentzville, MO 633853437
Phone: (636) 332-3390
Fax: (314) 227-5505
Type: Location
3009, North Ballas Road, Town and Country, Saint Louis County, Missouri, 63131, United States
BLDG A # 142
SAINT LOUIS, MO 631312322
Phone: (314) 993-4949
Fax: (314) 993-4945
Type: Location
PO BOX 653
CHESTERFIELD, MO 630060653
Phone: (314) 797-7074
Fax: (314) 227-5505
Type: Mailing
10420 OLD OLIVE STREET RD STE 305
SAINT LOUIS, MO 631415914
Phone: (314) 797-7074
Fax: (314) 227-5505
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2010-01-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-08-31 (650 days ago).
Enrollment records
1
Earliest due date
2024-08-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20100130000071 | O | Clinic/Group Practice | MO | 2024-08-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 63031)
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