Individual provider Active NPI

Sean E Goretzke, M.D.

  • Neurology with Special Qualifications in Child Neurology Physician
  • Saint Louis, MO
National Provider Identifier
1871794172
Registry record updated Mar 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
2007022244 Issued in MO
Practice address
1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone
(314) 268-4105
Fax
(314) 268-6411
NPI assigned
May 31, 2007
Last updated
Mar 17, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 2007022244 MO Primary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 036156296 IL

Addresses

Primary practice location

1465 S Grand Blvd
Saint Louis, MO 63104-1003

Mailing address

1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone (314) 268-4105

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other
Direct Messaging Address sgoretzke28710@direct-ehr-ssmhc.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100818000794 MO Practitioner - NeurologyPractitioner - Pediatric Medicine 7517091127 Reassigns benefits to 2 organizations
I20260302000799 IL Practitioner - Neurology 7517091127 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Saint Louis University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians

Practice addresses (Care Compare)

10101 Woodfield LN
Saint Louis, MO 63132-2946
Phone (608) 280-4647

1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone (314) 577-5641

Merit-based Incentive Payment System (MIPS)

Final score
84.94 of 100Reported as group
Quality
68.52
Promoting interoperability
100
Improvement activities
40
Cost
72.22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036156296ILMDNeurology with Special Qualifications in Child Neurology Physician
2007022244MOMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care Group CurrentSince Jul 1, 2022 Accepting new patients
Good Samaritan Regional Health Center CurrentSince Jan 18, 2026 Accepting new patients
Saint Francis Medical Center Current Accepting new patients
Good Samaritan Regional Health Center CurrentSince Jan 18, 2026 Accepting new patients
Saint Francis Medical Center CurrentSince Dec 1, 2024 Accepting new patients
St. Mary's Hospital, Centralia, Illinois CurrentSince Jan 18, 2026 Accepting new patients
St. Mary's Hospital, Centralia, Illinois CurrentSince Jan 18, 2026 Accepting new patients
SSM Health Care Group CurrentSince Jul 1, 2022 Accepting new patients
Saint Francis Medical Center CurrentSince Dec 1, 2024 Accepting new patients
SSM Medical Group Inc. Past Accepting new patients
SSM Cardinal Glennon Children's Hospital Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

400 N Pleasant Ave
Centralia, IL 62801
Phone (618) 436-5221

1 Good Samaritan Way
Mount Vernon, IL 62864
Phone (618) 242-4600

2 Good Samaritan Way
Ste 120
Mount Vernon, IL 62864
Phone (618) 899-4999

211 Saint Francis Dr
Cpe Girardeau, MO 63703
Phone (573) 331-3000

10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647

1145 Corporate Lake Dr
Saint Louis, MO 63132
Phone (314) 989-6189

1465 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 268-4070

3635 Vista Ave
Saint Louis, MO 63110
Phone (314) 577-8022

Interoperability endpoints

  • Direct secure messaging: sgoretzke28710@direct-ehr-ssmhc.com

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773705600000",
    "number": "1871794172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041003",
            "telephone_number": "314-268-4105",
            "fax_number": "314-268-6411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041003",
            "telephone_number": "314-268-4105",
            "fax_number": "314-268-6411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORETZKE",
        "first_name": "SEAN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-31",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "MO",
            "license": "2007022244",
            "primary": true
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "IL",
            "license": "036156296",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1465 S Grand Blvd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631041003",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sgoretzke28710@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1465 S Grand Blvd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631041003",
            "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.