Theresa T. Rickelman, D.O.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

2001014679 Issued in MO

Practice address

615 S New Ballas Rd Dept of
Saint Louis, MO 63141-8221

Phone

(636) 386-9224

Fax

(636) 386-7679

NPI assigned

Jul 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

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

Specialty

AnesthesiologyAlso: Pain Management

Education

At Still University of Health Sciences, College of Osteo Med, Kirksville, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthomed Staffing LLCGroup PAC ID 9638429178, 373 clinicians

Western Anesthesiology Associates IncGroup PAC ID 6204720667, 251 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Western Anesthesiology Associates, Inc.

  dba Western Anesthesiology Pain Management

  • Anesthesiology Physician
  • Saint Louis, MO
  • NPI 1275646754
  Medicare reassignment Care Compare group NPD
• Orthomed Staffing LLC

  • Anesthesiology Physician
  • Addison, TX
  • NPI 1225514276

  MO

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520899200000",
    "number": "1942220678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 CONSORT DR",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630114439",
            "telephone_number": "636-386-9224",
            "fax_number": "636-386-7679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S NEW BALLAS RD DEPT OF",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418221",
            "telephone_number": "636-386-9224",
            "fax_number": "636-386-7679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKELMAN",
        "first_name": "THERESA",
        "middle_name": "T.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2018-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "2001014679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0976845",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207178708",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCARE USA (GROUP)",
            "identifier": "8298",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CG4336",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCARE USA",
            "identifier": "80174",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00130500",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Randy R Richter
• Sara Grace Richter, P.T.
• Sara K. Richter, PHARM.D.
• Rick Hummel MD PC
• Mary Rickard, M.D.
• Ansley Beth Ricker, MD
• Eric R Ricker, OD
• Hailee Ann Ricker, MSAT, LAT, ATC
• Brian Anthony Rickert, RN
• Jared Rickert, D.O.

• Anesthesiology Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Anesthesiology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.