Individual provider Active NPI

Friederike Helene Kreisel, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Saint Louis, MO
National Provider Identifier
1962428185
Registry record updated Feb 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
2003009183 Issued in MO
Practice address
1402 S Grand Blvd
Saint Louis, MO 63104-1004
Phone
(314) 977-4547
Fax
(314) 977-7615
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Pathology) Physician 207ZH0000X 203009183 MO
Hematology (Pathology) Physician 207ZH0000X 036139216 IL
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 036139216 IL
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 2003009183 MO Primary

Addresses

Primary practice location

1402 S Grand Blvd
Saint Louis, MO 63104-1004

Mailing address

1402 S Grand Blvd
Saint Louis, MO 63104-1004
Phone (314) 977-4547

Other identifiers 2

IdentifierTypeStateIssuer
209180207MedicaidMO
ENROLLEDMedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address fkreisel384865@direct-ehr-ssmhc.com Direct
FHIR URL fkreisel384865@direct-ehr-ssmhc.com Other

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
I20040406001270 MO Practitioner - Pathology 5991798878 Reassigns benefits to 2 organizations
I20201111000162 IL Practitioner - Pathology 5991798878 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1995
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)

1 Good Samaritan Way
Mount Vernon, IL 62864-2402
Phone (618) 242-4600

10101 Woodfield LN
Saint Louis, MO 63132-2946

1402 S Grand Blvd
Saint Louis, MO 63104-1004
Phone (314) 577-8475

Hospital & facility affiliations

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
036139216ILMDHematology (Pathology) Physician
203009183MOMDHematology (Pathology) Physician
2003009183MOMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care Group CurrentSince Jul 1, 2022 Accepting new patients
SSM Cardinal Glennon Childrens Hospital CurrentSince Mar 18, 2021 Accepting new patients
SSM Cardinal Glennon Children's Hospital CurrentSince Mar 18, 2021 Accepting new patients
SSM Health Care Group Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2022 Accepting new patients

Locations

1 Saint Anthonys Way
Alton, IL 62002
Phone (618) 233-6870

7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189

6800 State Route 162
Maryville, IL 62062
Phone (618) 288-4095

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

1402 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 577-8762

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

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

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

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

Organizations & group practices 4

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1962428185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041004",
            "telephone_number": "314-977-4547",
            "fax_number": "314-977-7615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041004",
            "telephone_number": "314-977-4547",
            "fax_number": "314-977-7615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREISEL",
        "first_name": "FRIEDERIKE",
        "middle_name": "HELENE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZH0000X",
            "taxonomy_group": "",
            "desc": "Pathology, Hematology",
            "state": "MO",
            "license": "203009183",
            "primary": false
        },
        {
            "code": "207ZH0000X",
            "taxonomy_group": "",
            "desc": "Pathology, Hematology",
            "state": "IL",
            "license": "036139216",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "036139216",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MO",
            "license": "2003009183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209180207",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fkreisel384865@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "fkreisel384865@direct-ehr-ssmhc.com",
            "address_1": "1402 S Grand Blvd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631041004",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "fkreisel384865@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1402 S Grand Blvd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631041004",
            "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.