Greg Evan Raecker, DO

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

02087 Issued in IA

Practice address

1731 W Ridgeway Ave
Ste 101
Waterloo, IA 50701-4591

Phone

(319) 833-6001

Fax

(319) 833-6003

NPI assigned

Jun 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: graecker108408@direct.unitypoint.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.

• St Luke's Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189123200000",
    "number": "1225076029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2758",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507042758",
            "telephone_number": "319-833-6001",
            "fax_number": "319-833-6003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1731 W RIDGEWAY AVE",
            "address_2": "STE 101",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507014591",
            "telephone_number": "319-833-6001",
            "fax_number": "319-833-6003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAECKER",
        "first_name": "GREG",
        "middle_name": "EVAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2007-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IA",
            "license": "02087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE HLTH INS PLAN",
            "identifier": "42141730793",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK INS PLAN",
            "identifier": "56258",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5030635",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Quality Medical Services Inc
• Abbey Quinn
• Rose M. Quirk, MSW
• Sophia Tariq Qureshi, MD
• Tenzin Rabgay, MD
• Billie Joel Rael, PMHNP
• Alayna Ragain, CNM
• Albert Rahlf, CADC
• Micaela Jean Rahm, ARNP
• Joanna Rahnavardi, MAE, LMHC

• Diagnostic Radiology Physician in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Diagnostic Radiology Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.