Jon Edward Kretzler, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

MD00030913 Issued in WA

Practice address

625 9TH Ave
Ste 210
Longview, WA 98632-2465

Phone

(360) 501-3400

Fax

(360) 423-6862

NPI assigned

Feb 20, 2006

Last updated

Jul 25, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Longview Orthopedic Associates, PLLC

  • Orthopaedic Surgery Physician
  • Longview, WA
  • NPI 1003865072
  Medicare reassignment NPD
• The Vancouver Clinic Inc PS

  dba The Vancouver Clinic

  • Internal Medicine Physician
  • Vancouver, WA
  • NPI 1992759427
  Medicare reassignment NPD
• The Vancouver Clinic Inc PS

  dba Salmon Creek 2 Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Vancouver, WA
  • NPI 1306556907

  Orthopaedic Surgery

  NPD
• Longview Surgical Center LLC

  dba Pacific Surgical Center

  • Ambulatory Surgical Clinic/Center
  • Longview, WA
  • NPI 1750481453
  NPD (past)

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

{
    "created_epoch": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185321600000",
    "number": "1417922840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 9TH AVE",
            "address_2": "STE 210",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322465",
            "telephone_number": "360-501-3400",
            "fax_number": "360-423-6862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 9TH AVE",
            "address_2": "STE 210",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322465",
            "telephone_number": "360-501-3400",
            "fax_number": "360-423-6862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRETZLER",
        "first_name": "JON",
        "middle_name": "EDWARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-20",
        "last_updated": "2007-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WA",
            "license": "MD00030913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "057989",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1084128",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Magda Anna Kozyrczak
• Daphne Kraabell, CPSS
• Heather Marie Kraft, CG 61090134
• Michael Adam Krall, MD
• Marc Kranz, MD
• Justin Mehrtosh Kringel, DDS
• Kristin Kaelin, DMD, P.C.
• Linda F Krout
• Anna Gabriela Kruse, CAAR
• Lyudmila E Kruzhkov, M.D.

• Orthopaedic Surgery Physician in Longview, WA
• Providers in Longview, WA by specialty
• Orthopaedic Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2007; 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.

Verify at the official NPI Registry.