NPIMap

Individual provider Active NPI

Craig Alan Luetkemeyer, M.D.

  • Family Medicine Physician
  • Jefferson City, MO
National Provider Identifier
1013279967
Registry record updated Feb 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2012016483 Issued in MO
Practice address
1014 Madison St
Jefferson City, MO 65101-3458
Phone
(573) 644-6999
Fax
(573) 644-7880
NPI assigned
Jun 15, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2012016483 MO Primary

Addresses

Primary practice location

1014 Madison St
Jefferson City, MO 65101-3458

Mailing address

1014 Madison St
Jefferson City, MO 65101-3458
Phone (573) 644-6999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150818005630 MO Practitioner - Family Practice 5597909101 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Missouri, Columbia School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Curators of the University of MissouriGroup PAC ID 4486759560, 1,108 clinicians

Practice addresses (Care Compare)

1014 Madison St
Jefferson City, MO 65101-3458
Phone (573) 659-7300

Hospital & facility affiliations

  • Capital Region Home Health Home health agency, Jefferson City, MO, CCN 267219
  • Hospice Compassus-Central Missouri Hospice, Jefferson City, MO, CCN 261559
  • University of Missouri Health Care Hospital, Columbia, MO, CCN 260141

Merit-based Incentive Payment System (MIPS)

Final score
80.23 of 100Reported as group
Quality
58.17
Promoting interoperability
100
Improvement activities
40
Cost
75.92

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Ctr of Central Missouri Family Medicine Current Accepting new patients
Community Health Ctr of Central Missouri Family Medicine CurrentSince Jul 4, 2017 Accepting new patients
The Curators of the University of Missouri CurrentSince Jan 1, 2024 Accepting new patients
Curators of the University of Missouri CurrentSince Jan 1, 2024 Accepting new patients
Community Health Ctr of Central Missouri Family Medicine CurrentSince Jul 4, 2017 Accepting new patients
Capital Region Medical Center Past Accepting new patients

Locations

1 Hospital Dr
Columbia, MO 65212
Phone (573) 882-2568

1511 Christy Dr
Jefferson Cty, MO 65101
Phone (573) 606-6924

3308 W Edgewood Dr
Ste B
Jefferson Cty, MO 65109
Phone (573) 644-6999

1014 Madison St
Jefferson Cty, MO 65101
Phone (573) 632-5510

901 Kidwell Dr
Versailles, MO 65084
Phone (573) 378-4666

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1339718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455148800000",
    "number": "1013279967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 MADISON ST",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651013458",
            "telephone_number": "573-644-6999",
            "fax_number": "573-644-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 MADISON ST",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651013458",
            "telephone_number": "573-644-6999",
            "fax_number": "573-644-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUETKEMEYER",
        "first_name": "CRAIG",
        "middle_name": "ALAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-15",
        "last_updated": "2016-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2012016483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

Verify at the official NPI Registry.