Individual provider Active NPI

Cyrene D Grothaus-Day, MD

  • Pediatric Anesthesiology Physician
  • Fenton, MO
National Provider Identifier
1407872625
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X
License
2003019558 Issued in MO
Practice address
1378 Mosswoods Dr
Fenton, MO 63026-7226
Phone
(636) 861-1676
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Anesthesiology Physician 207LP3000X 2003019558 MO Primary
Pediatric Anesthesiology Physician 207LP3000X 036-126419 IL

Addresses

Primary practice location

1378 Mosswoods Dr
Fenton, MO 63026-7226

Mailing address

335 Davis Dr
Holts Summit, MO 65043-2135
Phone (561) 320-2958

Other identifiers 3

IdentifierTypeStateIssuer
204893622MedicaidMO
036126419MedicaidIL
336OtherMO-BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040102000499 MO Practitioner - Anesthesiology 8022917624 Reassigns benefits to 1 organization
I20101105000247 IL Practitioner - Anesthesiology 8022917624 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Resource Anesthesiology Associates of Mo LLC Anesthesiology CurrentSince Dec 28, 2016 Accepting new patients
Northstar Anesthesia of Illinois, LLC Anesthesiology CurrentSince Jun 1, 2022 Accepting new patients
Granite Peak Anesthesiology Consultants Anesthesiology Past Accepting new patients
Broad Midwest Anesthesia, LLC Anesthesiology Past Accepting new patients
HSHS Medical Group Inc Past Accepting new patients

Locations

1423 Chicago Rd
Sauk Village, IL 60411
Phone (708) 679-2160

1008 N Main St
Sikeston, MO 63801
Phone (573) 471-1600

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.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1407872625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 DAVIS DR",
            "city": "HOLTS SUMMIT",
            "state": "MO",
            "postal_code": "650432135",
            "telephone_number": "561-320-2958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1378 MOSSWOODS DR",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630267226",
            "telephone_number": "636-861-1676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROTHAUS-DAY",
        "first_name": "CYRENE",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "MO",
            "license": "2003019558",
            "primary": true
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "IL",
            "license": "036-126419",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204893622",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036126419",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO-BLUE SHIELD",
            "identifier": "336",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MO

Sources for this page

Verify at the official NPI Registry.