Individual provider Active NPI

Eric J Ruettgers, ANP

  • Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1801004817
Registry record updated Nov 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
110404 Issued in MO
Practice address
10 Barnes West Dr
Div Im Gastroenterology, Ste 200
Saint Louis, MO 63141-6287
Phone
(314) 747-1171
Fax
(314) 362-3192
NPI assigned
May 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 110404 MO Primary

Addresses

Primary practice location

10 Barnes West Dr
Div Im Gastroenterology, Ste 200
Saint Louis, MO 63141-6287

Mailing address

660 S Euclid Ave
CB 8058
Saint Louis, MO 63110-1010
Phone (314) 747-1171

Other identifiers 1

IdentifierTypeStateIssuer
424591709MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070802000600 MO Practitioner - Nurse Practitioner 2466543632 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
71.6
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Organizations & group practices 1

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": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1801004817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S EUCLID AVE",
            "address_2": "CB 8058",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101010",
            "telephone_number": "314-747-1171",
            "fax_number": "314-362-3192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 BARNES WEST DR",
            "address_2": "DIV IM GASTROENTEROLOGY, STE 200",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416287",
            "telephone_number": "314-747-1171",
            "fax_number": "314-362-3192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUETTGERS",
        "first_name": "ERIC",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "110404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "424591709",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "10 Barnes West Dr",
            "address_2": "Div IM Gastroenterology, Ste 200",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631416287",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.