Individual provider Active NPI

Jonathan Jay Beitler, MD, MBA, FACR

  • Radiation Oncology Physician
  • Saint Louis, MO
National Provider Identifier
1265536635
Registry record updated Jan 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
60043 Issued in GA
Practice address
915 N Grand Blvd
Saint Louis, MO 63106-1621
Phone
(314) 289-6324
NPI assigned
Sep 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Aerospace Medicine Physician 2083A0100X 043800 CT
Radiation Oncology Physician 2085R0001X 043800 CT
Radiation Oncology Physician 2085R0001X G63032 CA
Aerospace Medicine Physician 2083A0100X 154501 NY
Radiation Oncology Physician 2085R0001X 154501 NY
Radiation Oncology Physician 2085R0001X 60043 GA Primary

Addresses

Primary practice location

915 N Grand Blvd
Saint Louis, MO 63106-1621

Mailing address

1 Ogden Rd
New Canaan, CT 06840-2210
Phone (203) 972-0160

Other identifiers 2

IdentifierTypeStateIssuer
01191322MedicaidNY
467640604CMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20211110002637 ME Practitioner - Radiation Oncology 7012996762 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G63032CAMDRadiation Oncology Physician
043800CTMDRadiation Oncology Physician
60043GAMDRadiation Oncology Physician
154501NYMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiation Oncology Associates, PA CurrentSince Nov 1, 2021 Accepting new patients
Maimonides Division of Radiation Oncology, FPP Radiation Oncology Past Accepting new patients
Montefiore Medical Center Past Accepting new patients

Locations

361 Old Belgrade Rd
Augusta, ME 04330
Phone (207) 621-6100

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": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767830400000",
    "number": "1265536635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 OGDEN RD",
            "city": "NEW CANAAN",
            "state": "CT",
            "postal_code": "068402210",
            "telephone_number": "203-972-0160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 N GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631061621",
            "telephone_number": "314-289-6324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEITLER",
        "first_name": "JONATHAN",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "MD, MBA, FACR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "CT",
            "license": "043800",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CT",
            "license": "043800",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "G63032",
            "primary": false
        },
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "NY",
            "license": "154501",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NY",
            "license": "154501",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "GA",
            "license": "60043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01191322",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "467640604C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.