Individual provider Active NPI

Jordan A Freie, MD

  • Hospitalist Physician
  • Saint Louis, MO
National Provider Identifier
1366592925
Registry record updated Jul 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
2008005512 Issued in MO
Practice address
621 S New Ballas Rd
Suite 3016B
Saint Louis, MO 63141-8232
Phone
(314) 251-6339
Fax
(314) 251-4564
NPI assigned
Jan 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 2008005512 MO Primary

Addresses

Primary practice location

621 S New Ballas Rd
Suite 3016B
Saint Louis, MO 63141-8232

Mailing address

621 S New Ballas Rd
Suite 3016B
Saint Louis, MO 63141-8232
Phone (314) 251-6339

Other identifiers 2

IdentifierTypeStateIssuer
1366592925MedicaidMO
P00673724OtherMORAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20080512000266 MO Practitioner - Internal MedicinePractitioner - Hospitalist 3779504394 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
University of Missouri, Columbia School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Adult Hospitalists - St. Louis, LLCGroup PAC ID 6002809944, 139 clinicians

Practice addresses (Care Compare)

615 S New Ballas Rd
Saint Louis, MO 63141-8221

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2008005512MOMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Adult Hospitalists - St. Louis, LLC CurrentSince Mar 17, 2008 Accepting new patients
Mercy Clinic Adult Hospitalists - Washington, LLC Hospitalist CurrentSince Jul 23, 2019 Accepting new patients
Mercy Clinic Adult Hospitalists- Jefferson, LLC CurrentSince Jul 23, 2019 Accepting new patients
Mercy Hospitals East Communities CurrentSince Mar 1, 2008 Accepting new patients
Mercy Hospital Lincoln CurrentSince Jul 23, 2019 Accepting new patients
Mercy Hospitals East Communities CurrentSince Mar 1, 2008 Accepting new patients
St Anthonys Physician Organization Hospitalist Services, L.C. Hospitalist CurrentSince Jul 23, 2019 Accepting new patients
Mercy Hospitals East Communities Past Accepting new patients

Locations

1400 US Highway 61
Crystal Cty, MO 63028
Phone (636) 933-1111

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

615 S New Ballas Rd
#H
Saint Louis, MO 63141
Phone (314) 251-6075

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

621 S New Ballas Rd
Ste 3016B
Saint Louis, MO 63141
Phone (314) 251-6339

1000 E Cherry St
Troy, MO 63379
Phone (636) 528-3327

900 E Cherry St
Troy, MO 63379
Phone (636) 528-8585

901 E 5th St
Washington, MO 63090
Phone (636) 239-8000

Organizations & group practices 8

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 2

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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405382400000",
    "number": "1366592925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD",
            "address_2": "SUITE 3016B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418232",
            "telephone_number": "314-251-6339",
            "fax_number": "314-251-4564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD",
            "address_2": "SUITE 3016B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418232",
            "telephone_number": "314-251-6339",
            "fax_number": "314-251-4564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREIE",
        "first_name": "JORDAN",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2014-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "2008005512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366592925",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00673724",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.