Individual provider Active NPI

Samuel Ray Schroerlucke, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Memphis, TN
National Provider Identifier
1902028947
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
45727 Issued in TN
Practice address
1244 Primacy Pkwy
Memphis, TN 38119-0201
Phone
(901) 767-8662
Fax
(901) 767-8666
NPI assigned
May 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 45727 TN
Orthopaedic Surgery of the Spine Physician 207XS0117X 45727 TN Primary

Addresses

Primary practice location

1244 Primacy Pkwy
Memphis, TN 38119-0201

Mailing address

6077 Primacy Pkwy Ste 140
Memphis, TN 38119-5742
Phone (901) 725-8347

Other practice location 1

3045 Kate Bond Rd
Bartlett, TN 38133-4004
Phone (901) 725-8347

Other practice location 2

1350 Concourse Ave Ste 363
Memphis, TN 38104-2023
Phone (901) 260-6161

Other identifiers 6

IdentifierTypeStateIssuer
4269099OtherTNBCBS TN
9993516OtherTNAETNA
P00881379OtherTNRAILROAD MEDICARE
1521876MedicaidTN
620819926OtherTNAETNA
620819926OtherTXCIGNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20101027000080 TN Practitioner - Orthopedic Surgery 4789878497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Medical College of Georgia School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MSK Group PCGroup PAC ID 4688574262, 138 clinicians

Practice addresses (Care Compare)

13690 Hwy 51 S
Suite 104
Atoka, TN 38004-7645
Phone (901) 641-3000

6286 Briarcrest Ave
Memphis, TN 38120-4023

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion419
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
MSK Group, PC Orthopaedic Surgery CurrentSince Aug 2, 2010 Accepting new patients
MSK Group, PC Orthopaedic Surgery CurrentSince Aug 2, 2010 Accepting new patients
MSK Group PC Orthopaedic Surgery Past Accepting new patients

Locations

8010 Stage Hills Blvd
Bartlett, TN 38133
Phone (901) 937-3200

3045 Kate Bond Rd
Bartlett, TN 38133
Phone (901) 381-4664

2100 Exeter Rd
Ste 200
Germantown, TN 38138
Phone (901) 522-6440

6029 Walnut Grove Rd
Ste 403
Memphis, TN 38120
Phone (901) 261-7836

6077 E Primacy Pkwy
Ste 140
Memphis, TN 38119
Phone (901) 725-8347

6286 Briarcrest Ave
Ste 100
Memphis, TN 38120
Phone (901) 259-1600

1350 Concourse Ave
Ste 363
Memphis, TN 38104
Phone (901) 260-6155

6286 Briarcrest Ave
#200
Memphis, TN 38120
Phone (901) 259-1600

1244 Primacy Pkwy
Memphis, TN 38119
Phone (901) 767-8662

Interoperability endpoints

  • Direct secure messaging: sschroerlucke33489@mlh.direct-ci.com

Organizations & group practices 3

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": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1902028947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6077 PRIMACY PKWY STE 140",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195742",
            "telephone_number": "901-725-8347",
            "fax_number": "901-259-7637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1244 PRIMACY PKWY",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381190201",
            "telephone_number": "901-767-8662",
            "fax_number": "901-767-8666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3045 Kate Bond Rd",
            "address_purpose": "LOCATION",
            "city": "Bartlett",
            "state": "TN",
            "postal_code": "381334004",
            "country_code": "US",
            "telephone_number": "901-725-8347",
            "fax_number": "901-259-7637",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1350 Concourse Ave Ste 363",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381042023",
            "country_code": "US",
            "telephone_number": "901-260-6161",
            "fax_number": "901-260-6162",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHROERLUCKE",
        "first_name": "SAMUEL",
        "middle_name": "RAY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TN",
            "license": "45727",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "TN",
            "license": "45727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TN",
            "identifier": "4269099",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9993516",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00881379",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1521876",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "620819926",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "620819926",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.