NPIMap

Individual provider Active NPI

Adam Blaine Kretzer, MD

  • Anesthesiology Physician
  • Dallas, TX
National Provider Identifier
1881835213
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
S3009 Issued in TX
Practice address
12222 Merit Dr Ste 600
Dallas, TX 75251-3294
Phone
(972) 715-5000
Fax
(972) 715-9976
NPI assigned
Mar 14, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X S3009 TX Primary
Anesthesiology Physician 207L00000X 036.135351 IL
Anesthesiology Physician 207L00000X MD61513824 WA
Critical Care Medicine (Anesthesiology) Physician 207LC0200X MD61513824 WA

Addresses

Primary practice location

12222 Merit Dr Ste 600
Dallas, TX 75251-3294

Mailing address

PO Box 840853
Dallas, TX 75284-0853
Phone (972) 233-1999

Other practice location 1

251 E Huron St, F5-704
Northwestern Memorial Hospital Department of Anesthesia
Chicago, IL 60611-2908
Phone (312) 695-0061

Other practice location 2

6606 Lyndon B Johnson Fwy Ste 200
Dallas, TX 75240-6524
Phone (972) 715-5000

Other practice location 3

1717 S J St
Tacoma, WA 98405-4933
Phone (253) 426-6341

Other identifiers 1

IdentifierTypeStateIssuer
2280440MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, NE, NY3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20240530002299 WA Practitioner - Anesthesiology 5395069801 Reassigns benefits to 1 organization
I20240604001356 NE Practitioner - Anesthesiology 5395069801 Reassigns benefits to 1 organization
I20260214000027 NY Practitioner - Anesthesiology 5395069801 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Kansas School of Med (KC/Wich/Sal), 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians
Great Lakes Anesthesiology PCGroup PAC ID 7113997529, 90 clinicians
CHI Health Clinic Physician Enterprise-Anesthesia LLCGroup PAC ID 2264794569, 224 clinicians

Practice addresses (Care Compare)

1717 S J St
Tacoma, WA 98405-4933
Phone (253) 426-6341

2605 Harlem Rd
Cheektowaga, NY 14225-4018
Phone (716) 323-6570

7500 Mercy Rd
Omaha, NE 68124-2319
Phone (402) 717-4866

Hospital & facility affiliations

  • CHI Health Bergan Mercy Hospital, Omaha, NE, CCN 280060
  • Mercy Hospital of Buffalo Hospital, Buffalo, NY, CCN 330279
  • CHI Health Nebraska Heart Hospital, Lincoln, NE, CCN 280128
  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.135351ILMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CHI Health Clinic Physician Enterprise-Anesthesia LLC Anesthesiology CurrentSince Apr 28, 2024 Accepting new patients
Franciscan Medical Group Anesthesiology CurrentSince Apr 8, 2024 Accepting new patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group CurrentSince Apr 8, 2024 Accepting new patients
Great Lakes Anesthesiology, PC CurrentSince Jan 1, 2026 Accepting new patients
CHI Health Clinic Physician Enterprise-Anesthesia LLC Anesthesiology Past Accepting new patients

Locations

7500 Mercy Rd
Ste 1355
Omaha, NE 68124
Phone (402) 717-4866

7261 Mercy Rd
Omaha, NE 68124
Phone (402) 398-6248

7500 Mercy Rd
Omaha, NE 68124
Phone (402) 398-5880

2605 Harlem Rd
Cheektowaga, NY 14225
Phone (716) 891-2315

3095 Harlem Rd
Cheektowaga, NY 14225
Phone (716) 896-2245

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Interoperability endpoints

  • Direct secure messaging: akretzer42700@direct.rush.rush-health.com

Organizations & group practices 6

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 7

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": "1236988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1881835213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840853",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840853",
            "telephone_number": "972-233-1999",
            "fax_number": "972-233-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12222 MERIT DR STE 600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752513294",
            "telephone_number": "972-715-5000",
            "fax_number": "972-715-9976"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "251 E Huron St, F5-704",
            "address_2": "Northwestern Memorial Hospital Department of Anesthesia",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112908",
            "country_code": "US",
            "telephone_number": "312-695-0061",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6606 Lyndon B Johnson Fwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752406524",
            "country_code": "US",
            "telephone_number": "972-715-5000",
            "fax_number": "972-715-9976",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1717 S J St",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984054933",
            "country_code": "US",
            "telephone_number": "253-426-6341",
            "fax_number": "253-426-6344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRETZER",
        "first_name": "ADAM",
        "middle_name": "BLAINE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-14",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "S3009",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036.135351",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "MD61513824",
            "primary": false
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "WA",
            "license": "MD61513824",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2280440",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.