Individual provider Active NPI

Andrew Edward Kreutzer

  • Nurse Practitioner
  • Lake St Louis, MO
National Provider Identifier
1811858053
Registry record updated Feb 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2015022724 Issued in MO
Practice address
100 Medical PLZ
Lake St Louis, MO 63367-1366
Phone
(636) 625-5200
NPI assigned
Nov 18, 2025
Last updated
Feb 20, 2026By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2015022724 MO Primary
Internal Medicine Physician 207R00000X 2025046992 MO

Addresses

Primary practice location

100 Medical PLZ
Lake St Louis, MO 63367-1366

Mailing address

4413 Thicket Dr
Oakville, MO 63129-3730
Phone (618) 719-1293

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
I20260303001705 MO Practitioner - Nurse Practitioner 9032691712 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sound Physicians of Illinois LLCGroup PAC ID 1557533734, 193 clinicians

Practice addresses (Care Compare)

100 Medical PLZ
Lake Saint Louis, MO 63367-1366
Phone (636) 625-5200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2025046992MOMDInternal Medicine Physician
2015022724MOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians of Illinois, LLC Multi-Specialty CurrentSince Mar 1, 2026 Accepting new patients

Locations

100 Medical Plz
Lake St Louis, MO 63367
Phone (636) 625-5200

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1763424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771545600000",
    "number": "1811858053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4413 THICKET DR",
            "city": "OAKVILLE",
            "state": "MO",
            "postal_code": "631293730",
            "telephone_number": "618-719-1293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL PLZ",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "633671366",
            "telephone_number": "636-625-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREUTZER",
        "first_name": "ANDREW",
        "middle_name": "EDWARD",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2025-11-18",
        "last_updated": "2026-02-20",
        "certification_date": "2026-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2015022724",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2025046992",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake St Louis, MO

Sources for this page

Verify at the official NPI Registry.