Individual provider Active NPI

Jeffrey Thomas Kreikemeier, M.D.

  • Gastroenterology Physician
  • Chesterfield, MO
National Provider Identifier
1063456986
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
2002007685 Issued in MO
Practice address
121 Saint Lukes Center Dr
Suite 406
Chesterfield, MO 63017-3518
Phone
(314) 529-4900
Fax
(314) 849-4423
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 2002007685 MO
Gastroenterology Physician 207RG0100X 2002007685 MO Primary

Addresses

Primary practice location

121 Saint Lukes Center Dr
Suite 406
Chesterfield, MO 63017-3518

Mailing address

915 N Grand Blvd
Saint Louis, MO 63106-1621
Phone (314) 289-6434

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20210923003232 MT Practitioner - Gastroenterology 7113985581 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.28 of 100Reported as group
Quality
94
Promoting interoperability
100
Improvement activities
40
Cost
73.6

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as group
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2002007685MOMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montana Gastroenterology, PLLC CurrentSince Oct 1, 2021 Accepting new patients
Chesterfield Anesthesia Associates of Missouri, LLC PastSince May 1, 2015 Accepting new patients
Mercy Hospitals East Communities PastSince Nov 14, 2022 Accepting new patients

Locations

500 W Broadway St
Ste A
Missoula, MT 59802
Phone (406) 284-5560

1930 W Broadway St
Ste B
Missoula, MT 59808
Phone (406) 541-6836

1930 W Broadway St
Ste A
Missoula, MT 59808
Phone (406) 541-6844

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1063456986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 N GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631061621",
            "telephone_number": "314-289-6434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 SAINT LUKES CENTER DR",
            "address_2": "SUITE 406",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173518",
            "telephone_number": "314-529-4900",
            "fax_number": "314-849-4423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREIKEMEIER",
        "first_name": "JEFFREY",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MO",
            "license": "2002007685",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MO",
            "license": "2002007685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.