Jerold Jay Kreisman, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

R6606 Issued in MO

Practice address

11477 Olde Cabin Rd
Ste 200
Saint Louis, MO 63141-7076

Phone

(314) 567-5000

Fax

(314) 567-3110

NPI assigned

Aug 29, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 10, 2016 through Feb 10, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Allied Behavioral Consultants, Inc.

  • Psychiatry Physician
  • Saint Louis, MO
  • NPI 1366536120
  NPD (past)

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289347200000",
    "number": "1497864185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11477 OLDE CABIN RD",
            "address_2": "STE 200",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417130",
            "telephone_number": "314-567-5000",
            "fax_number": "314-567-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11477 OLDE CABIN RD",
            "address_2": "STE 200",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417076",
            "telephone_number": "314-567-5000",
            "fax_number": "314-567-3110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREISMAN",
        "first_name": "JEROLD",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2010-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "R6606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Loren Kreher
• Julie Ann Kreidler, D.C.
• Christina Ann Kreilich, M.S. CCC-SLP
• Daniel Kreisel, MD
• Friederike Helene Kreisel, MD
• Judith K. Kreisman, M.S.W., A.C.S.W.
• Michael A Kreitler, MA, LPC
• Megan Elizabeth Kreitman
• Vladimir Krejci, MD
• Jordyn Lynn Frances Kreke, MD

• Psychiatry Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Psychiatry Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2010; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.