Individual provider Active NPI

Ryan Lee Kroeger, D.O.

  • Internal Medicine Physician
  • St. Louis, MO
National Provider Identifier
1801150784
Registry record updated Feb 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2014002055 Issued in MO
Practice address
615 S New Ballas
Mercy Hospital Internal Medicine Department
St. Louis, MO 63141-8277
Phone
(314) 251-5834
Fax
(314) 251-4454
NPI assigned
Jun 26, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2014002055 MO Primary

Addresses

Primary practice location

615 S New Ballas
Mercy Hospital Internal Medicine Department
St. Louis, MO 63141-8277

Mailing address

615 S New Ballas
Mercy Hospital Internal Medicine Department
St. Louis, MO 63141-8277
Phone (314) 251-5834

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150923002776 MO Practitioner - Internal MedicinePractitioner - Hospitalist 9638397326 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Adult Hospitalists - St. Louis, LLCGroup PAC ID 6002809944, 139 clinicians
Mercy Hospitals East CommunitiesGroup PAC ID 1658276811, 92 clinicians

Practice addresses (Care Compare)

615 S New Ballas Rd
Saint Louis, MO 63141-8221

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Anthonys Physician Organization Hospitalist Services, L.C. CurrentSince Sep 17, 2019 Accepting new patients
Mercy Clinic Adult Hospitalists - Washington, LLC CurrentSince Sep 17, 2019 Accepting new patients
Mercy Hospital Lincoln Internal Medicine CurrentSince Sep 17, 2019 Accepting new patients
Mercy Clinic Adult Hospitalists - St. Louis, LLC Internal Medicine CurrentSince Jul 1, 2015 Accepting new patients
Mercy Hospitals East Communities CurrentSince Jul 1, 2015 Accepting new patients
Mercy Clinic Adult Hospitalists- Jefferson, LLC Internal Medicine CurrentSince Sep 17, 2019 Accepting new patients
Mercy Hospitals East Communities CurrentSince Jul 1, 2015 Accepting new patients

Locations

1400 US Highway 61
Crystal Cty, MO 63028
Phone (636) 933-1111

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

615 S New Ballas Rd
#H
Saint Louis, MO 63141
Phone (314) 251-6075

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

900 E Cherry St
Troy, MO 63379
Phone (636) 528-8585

901 E 5th St
Washington, MO 63090
Phone (636) 239-8000

Organizations & group practices 7

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1340668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393286400000",
    "number": "1801150784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 S NEW BALLAS",
            "address_2": "MERCY HOSPITAL INTERNAL MEDICINE DEPARTMENT",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "631418277",
            "telephone_number": "314-251-5834",
            "fax_number": "314-251-4454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S NEW BALLAS",
            "address_2": "MERCY HOSPITAL INTERNAL MEDICINE DEPARTMENT",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "631418277",
            "telephone_number": "314-251-5834",
            "fax_number": "314-251-4454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROEGER",
        "first_name": "RYAN",
        "middle_name": "LEE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-26",
        "last_updated": "2014-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2014002055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St. Louis, MO

Sources for this page

Verify at the official NPI Registry.