Grant Watson Gerdelman, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

036.143211 Issued in IL

Practice address

3635 Vista Ave
Saint Louis, MO 63110-2539

Phone

(314) 577-8780

Fax

(314) 577-8516

NPI assigned

Jul 9, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Emergency Medicine

Education

Saint Louis University School of Medicine, 2012

Medicare assignment

May accept Medicare assignment

Group practices

Ahs Il Medical Group LLCGroup PAC ID 5496111676, 46 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Gateway Regional Medical Center Hospital, Granite City, IL, CCN 140125

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

95

Improvement activities

40

Cost

80.65

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ggerdelm@yourcarecommunity.org

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.

• Ahs Il Medical Group LLC

  • Clinic/Center
  • Granite City, IL
  • NPI 1659098101
  Medicare reassignment Care Compare group NPD
• Alton-Griffin Emergency Group PC

  • Emergency Medicine Physician
  • Alton, IL
  • NPI 1891104824
  Medicare reassignment NPD

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

• American Healthcare Systems Illinois LLC

  • General Acute Care Hospital
  • Granite City, IL
  • NPI 1326765884
  Care Compare affiliation
• American Healthcare Systems Illinois LLC

  • Urgent Care Clinic/Center
  • Glen Carbon, IL
  • NPI 1700586344

  Hospital

  Care Compare affiliation
• American Healthcare Systems Illinois LLC

  • Clinic/Center
  • Edwardsville, IL
  • NPI 1760182307

  Hospital

  Care Compare affiliation
• American Healthcare Systems Illinois LLC

  • Clinic/Center
  • Waterloo, IL
  • NPI 1770283301

  Hospital

  Care Compare affiliation
• American Healthcare Systems Illinois LLC

  • Urgent Care Clinic/Center
  • Columbia, IL
  • NPI 1982304523

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1341792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500940800000",
    "number": "1215292933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3635 VISTA AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102539",
            "telephone_number": "314-577-8780",
            "fax_number": "314-577-8516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3635 VISTA AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102539",
            "telephone_number": "314-577-8780",
            "fax_number": "314-577-8516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERDELMAN",
        "first_name": "GRANT",
        "middle_name": "WATSON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-09",
        "last_updated": "2017-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2012023082",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036.143211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James M Gerard, MD
• Michael Pineda Gerardo, D.O.
• James Preston Gerber, PHD
• Jean Mary Gerber, RD
• William R Gerber, M.D.
• Kenneth L Gerdes, M.D.
• Peggy J Gerdes, RN, APN
• Michael L Gerdine, D.C
• Samantha A Gereau, SLP
• Jennifer Alice Gereaux, MD

• Emergency Medicine Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Emergency Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.