Active NPI
Jonathan Jay Beitler, MD, MBA, FACR
- Radiation Oncology Physician
- Saint Louis, MO
National Provider Identifier
1265536635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Physician
- License
- 60043
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01191322 | Medicaid | NY | |
| 467640604C | Medicaid | GA |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| G63032 | CA | MD | Radiation Oncology Physician |
| 043800 | CT | MD | Radiation Oncology Physician |
| 60043 | GA | MD | Radiation Oncology Physician |
| 154501 | NY | MD | Radiation Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Radiation Oncology Associates, PA | Current | 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.
-
- Radiation Oncology Physician
- Brooklyn, NY
- NPI 1841203056
Radiation Oncology
-
- Anesthesiology Physician
- Bronx, NY
- NPI 1063525152
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2026; 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.