Individual provider Active NPI

Erich Mertensmeyer, D.O.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Springfield, MO
National Provider Identifier
1396861498
Registry record updated Sep 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
2003013945 Issued in MO
Practice address
1229 E Seminole St
Ste 520
Springfield, MO 65804-2227
Phone
(417) 820-5750
Fax
(417) 820-5066
NPI assigned
Mar 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngic Allergy Physician 207YX0602X 2003013945 MO
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 2003013945 MO Primary

Addresses

Primary practice location

1229 E Seminole St
Ste 520
Springfield, MO 65804-2227

Mailing address

1229 E Seminole St
Springfield, MO 65804-2227
Phone (417) 829-5750

Other identifiers 4

IdentifierTypeStateIssuer
1396861498MedicaidMO
191683003MedicaidAR
431560263OtherMOTRICARE
P01036353OtherMORR MCR

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
I20040820000079 MO Practitioner - Otolaryngology 8022082601 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Joplin LLCGroup PAC ID 0547300196, 288 clinicians
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

100 Mercy Way
560 Mercy Clinic ENT
Joplin, MO 64804-4524
Phone (417) 556-8566

120 Hospital Dr
Suite 250
Lebanon, MO 65536-9230
Phone (417) 820-5750

1229 E Seminole St
Springfield, MO 65804-2227
Phone (417) 820-5750

Hospital & facility affiliations

  • Mercy Hospital Springfield Hospital, Springfield, MO, CCN 260065

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2003013945MOMDOtolaryngology/Facial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Mar 1, 2012 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Mar 1, 2012 Accepting new patients
Mercy Clinic Joplin LLC CurrentSince Nov 12, 2024 Accepting new patients
Mercy Clinic Joplin LLC CurrentSince Nov 12, 2024 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

100 Mercy Way
Ste 560
Joplin, MO 64804
Phone (417) 556-8555

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300

120 Hospital Dr
Ste 250
Lebanon, MO 65536
Phone (417) 533-6710

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

620 S Glenstone Ave
Springfield, MO 65802
Phone (417) 829-4215

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

Interoperability endpoints

  • Direct secure messaging: emertensmeyer250135@directb.mercy.net

Organizations & group practices 5

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 9

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569369600000",
    "number": "1396861498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1229 E SEMINOLE ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042227",
            "telephone_number": "417-829-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1229 E SEMINOLE ST",
            "address_2": "STE 520",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042227",
            "telephone_number": "417-820-5750",
            "fax_number": "417-820-5066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERTENSMEYER",
        "first_name": "ERICH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2019-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "MO",
            "license": "2003013945",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "MO",
            "license": "2003013945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396861498",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "191683003",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "431560263",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "P01036353",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.