Individual provider Active NPI

Rosanne L Sutter, MD

  • Family Medicine Physician
  • Belleville, IL
National Provider Identifier
1154422673
Registry record updated Oct 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-103098 Issued in IL
Practice address
211 S 3Rd St
Belleville, IL 62220-1915
Phone
(618) 234-2120
NPI assigned
Sep 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2007

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 036-103098 IL Primary

Addresses

Primary practice location

211 S 3Rd St
Belleville, IL 62220-1915

Mailing address

PO Box 8882
Fort Worth, TX 76124-0882
Phone (817) 451-4208

Other identifiers 2

IdentifierTypeStateIssuer
036103098MedicaidIL
08232204OtherILBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20040430000710 IL Practitioner - Family PracticePractitioner - Emergency Medicine 5991792855 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Deaconess Illinois Specialty Clinic, Inc.Group PAC ID 9830562016, 145 clinicians

Practice addresses (Care Compare)

325 Spring St
Red Bud, IL 62278-1105
Phone (618) 939-2273

Hospital & facility affiliations

  • Red Bud Regional Hospital Hospital, Red Bud, IL, CCN 141348

Merit-based Incentive Payment System (MIPS)

Final score
77.51 of 100Reported as group
Quality
49.04
Promoting interoperability
95
Improvement activities
40
Cost
69.42

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-103098ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Illinois Clinic, Inc Family Medicine CurrentSince Jan 14, 2023 Accepting new patients
Deaconess Illinois Specialty Clinic, Inc. Family Medicine CurrentSince Jan 14, 2023 Accepting new patients
Deaconess Illinois Red Bud Regional Hospital Inc Family Medicine CurrentSince Jan 14, 2023 Accepting new patients
Deaconess Illinois Red Bud Regional Hospital Inc CurrentSince Jan 14, 2023 Accepting new patients
Deaconess Illinois Clinic, Inc Family Medicine CurrentSince Jan 14, 2023 Accepting new patients
Deaconess Illinois Clinic, Inc Family Medicine Current Accepting new patients
Deaconess Illinois Specialty Clinic, Inc. CurrentSince Jan 14, 2023 Accepting new patients
Pamella S Gronemeyer Past Accepting new patients
Midwest Emergency Services Inc Past Accepting new patients
Mercy Hospital South Past Accepting new patients
Midwest Emergency Department Services Inc Past Accepting new patients

Locations

205 Bailey Ln
Benton, IL 62812
Phone (618) 435-8189

1000 Eleven S
Columbia, IL 62236
Phone (618) 281-7010

303 S Commercial St
Harrisburg, IL 62946
Phone (618) 767-6050

325 Spring St
Redbud, IL 62278
Phone (618) 282-5165

818 E Broadway St
Sparta, IL 62286
Phone (618) 443-2177

509 Hamacher St
Waterloo, IL 62298
Phone (618) 939-3939

Interoperability endpoints

  • Direct secure messaging: rosanne.sutter.1@27782.direct.athenahealth.com
  • Direct secure messaging: rsutte01@yourcarecommunity.org

Organizations & group practices 11

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 1

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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192752000000",
    "number": "1154422673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8882",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761240882",
            "telephone_number": "817-451-4208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 S 3RD ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201915",
            "telephone_number": "618-234-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTER",
        "first_name": "ROSANNE",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-103098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036103098",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "08232204",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

Verify at the official NPI Registry.