Individual provider Active NPI

Kenneth W Retter, MD

  • Interventional Cardiology Physician
  • Cape Girardeau, MO
National Provider Identifier
1033152335
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
MO103268 Issued in MO
Practice address
211 Saint Francis Dr Ste 15
Cape Girardeau, MO 63703-5049
Phone
(573) 331-3333
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X MO103268 MO Primary

Addresses

Primary practice location

211 Saint Francis Dr Ste 15
Cape Girardeau, MO 63703-5049

Mailing address

PO Box 801143
Kansas City, MO 64180-1143
Phone (573) 331-3000

Other identifiers 1

IdentifierTypeStateIssuer
207641804MedicaidMO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091015000410 MO Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 9830179696 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine
Education
Indiana University School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Francis Medical CenterGroup PAC ID 9931007929, 441 clinicians

Practice addresses (Care Compare)

211 Saint Francis Dr
Suite 15
Cape Girardeau, MO 63703-5049
Phone (573) 331-3333

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
67.07 of 100Reported as apm
Quality
85.4
Promoting interoperability
0
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting24
Coronary artery bypass graft (CABG)1-10
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MO103268MOMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Francis Medical Center Current Accepting new patients
Southeast Missouri Hospital Physicians, LLC CurrentSince Jan 1, 2012 Accepting new patients
Cape Laboratory & Pathology, LC Current Accepting new patients
Saint Francis Medical Center CurrentSince Mar 13, 2024 Accepting new patients

Locations

371 S Broadview St
Cape Girardeau, MO 63703
Phone (573) 331-6710

211 Saint Francis Dr
Ste 15
Cape Girardeau, MO 63703
Phone (573) 331-3333

211 Saint Francis Dr
Cpe Girardeau, MO 63703
Phone (573) 331-3000

25 Doctors Park
Cpe Girardeau, MO 63703
Phone (573) 331-6750

1701 Lacey St
Cpe Girardeau, MO 63701
Phone (573) 334-4822

Interoperability endpoints

  • Direct secure messaging: kretter16513@surescripts.sfmc.net

Organizations & group practices 4

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 2

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1033152335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801143",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641801143",
            "telephone_number": "573-331-3000",
            "fax_number": "573-331-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 SAINT FRANCIS DR STE 15",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637035049",
            "telephone_number": "573-331-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RETTER",
        "first_name": "KENNETH",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MO",
            "license": "MO103268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207641804",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.