Individual provider Active NPI

Craig R Hildreth, M.D.

  • Medical Oncology Physician
  • Saint Louis, MO
National Provider Identifier
1851393136
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
R6F58 Issued in MO
Practice address
10004 Kennerly Rd Ste 137a
Saint Louis, MO 63128-2140
Phone
(314) 842-7301
Fax
(314) 842-7308
NPI assigned
Aug 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X R6F58 MO Primary

Addresses

Primary practice location

10004 Kennerly Rd Ste 137a
Saint Louis, MO 63128-2140

Mailing address

10004 Kennerly Rd Ste 137a
Saint Louis, MO 63128-2140
Phone (314) 842-7301

Other practice location 1

533 Couch Ave
G-20
Saint Louis, MO 63122-5561
Phone (314) 965-6411

Other identifiers 1

IdentifierTypeStateIssuer
203709100MedicaidMO

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
I20100210000614 MO Practitioner - Hematology/Oncology 2264592054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
University of Iowa, RJ & L Carver College of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Louis Cancer Care LLP 3 clinicians

Practice addresses (Care Compare)

10004 Kennerly Rd
Suite 137a
Saint Louis, MO 63128-2140
Phone (314) 842-7301

10004 Kennerly Rd
Suite 137a
Saint Louis, MO 63128-2141

226 S Woods Mill Rd
Suite 45W
Chesterfield, MO 63017-3663
Phone (314) 579-0051

Hospital & facility affiliations

  • Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077
  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
  • Missouri Baptist Medical Center Hospital, Saint Louis, MO, CCN 260108

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Louis Cancer Care, L.L.P. CurrentSince Dec 31, 1991 Accepting new patients

Locations

226 S Woods Mill Rd
Ste 45W
Chesterfield, MO 63017
Phone (314) 205-6160

1551 Wall St
Ste 400
Saint Charles, MO 63303
Phone (636) 462-6106

1031 Bellevue Ave
Ste 300
Saint Louis, MO 63117
Phone (314) 647-9444

10004 Kennerly Rd
Ste 137A
Saint Louis, MO 63128
Phone (314) 842-7301

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.

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": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1851393136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10004 KENNERLY RD STE 137A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282140",
            "telephone_number": "314-842-7301",
            "fax_number": "314-842-7308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10004 KENNERLY RD STE 137A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282140",
            "telephone_number": "314-842-7301",
            "fax_number": "314-842-7308"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "533 Couch Ave",
            "address_2": "G-20",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631225561",
            "country_code": "US",
            "telephone_number": "314-965-6411",
            "fax_number": "314-965-1339",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HILDRETH",
        "first_name": "CRAIG",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "MO",
            "license": "R6F58",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203709100",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.