Robert Elroy Kraetsch, MD

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

R6140 Issued in MO

Practice address

400 Medical PLZ
Suite 100
Lake St Louis, MO 63367-1490

Phone

(636) 639-8600

Fax

(636) 639-8666

NPI assigned

Apr 6, 2006

Last updated

Aug 27, 2012By 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 7

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

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.

• Missouri Cancer Care PC

  • Hematology & Oncology Physician
  • Lake St Louis, MO
  • NPI 1326107871
  NPD

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346025600000",
    "number": "1609839281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 MEDICAL DR",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633853421",
            "telephone_number": "636-327-1202",
            "fax_number": "363-327-1222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MEDICAL PLZ",
            "address_2": "SUITE 100",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "633671490",
            "telephone_number": "636-639-8600",
            "fax_number": "636-639-8666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAETSCH",
        "first_name": "ROBERT",
        "middle_name": "ELROY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2012-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MO",
            "license": "R6140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110189320",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "3603013",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "121347",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "134622",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4000561",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP",
            "identifier": "58811",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202536827",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marissa Kistner, M.ED., LPC
• Kathleen M. Kloeckner, ANP-BC
• Michelle J. Koerner, MED, LPC
• Melvin Eugene Kottwitz, RPH
• Tia L Kraemer, MA, LPC
• Andrew Edward Kreutzer
• Lana Marie Kruse, RD, LD
• Makayla Denise Kulpa
• Laboratory Corporation of America
• Abhay Atul Laddu, M.D.

• Hematology & Oncology Physician in Lake St Louis, MO
• Providers in Lake St Louis, MO by specialty
• Hematology & Oncology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2012; 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.