Individual provider Active NPI

Van Schaumburg Krueger, MD, MBA

  • Orthopaedic Surgery Physician
  • Creve Coeur, MO
National Provider Identifier
1972032753
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
2024000213 Issued in MO
Practice address
11330 Olive Blvd Ste 150
Creve Coeur, MO 63141-7149
Phone
(314) 782-1994
Fax
(314) 948-9010
NPI assigned
Jun 6, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X A184896 CA
Orthopaedic Surgery Physician 207X00000X MD18287 RI
Orthopaedic Surgery Physician 207X00000X 2024000213 MO Primary

Addresses

Primary practice location

11330 Olive Blvd Ste 150
Creve Coeur, MO 63141-7149

Mailing address

11330 Olive Blvd Ste 150
Creve Coeur, MO 63141-7149
Phone (314) 782-1994

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240708002966 MO Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 3577832047 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Sports Medicine
Education
Tulane University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ortho Missouri LLCGroup PAC ID 8527417229, 7 clinicians

Practice addresses (Care Compare)

11330 Olive Blvd
Suite 150
Creve Coeur, MO 63141-7149
Phone (314) 782-1994

9594 Manchester Rd
Saint Louis, MO 63119-1313
Phone (314) 274-6314

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A184896CAMDOrthopaedic Surgery Physician
MD18287RIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ortho Missouri, LLC Orthopaedic Surgery CurrentSince Aug 15, 2024 Accepting new patients

Locations

201 S Mount Auburn Rd
Ste C
Cape Girardeau, MO 63703
Phone (573) 381-0780

760 Office Pkwy
Ste 200
Creve Coeur, MO 63141
Phone (314) 782-1994

11330 Olive Blvd
Ste 150
Saint Louis, MO 63141
Phone (314) 336-2566

Organizations & group practices 2

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": "1496707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1972032753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11330 OLIVE BLVD STE 150",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631417149",
            "telephone_number": "314-782-1994",
            "fax_number": "314-948-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11330 OLIVE BLVD STE 150",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631417149",
            "telephone_number": "314-782-1994",
            "fax_number": "314-948-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "VAN",
        "middle_name": "SCHAUMBURG",
        "name_prefix": "Dr.",
        "credential": "MD, MBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-06",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A184896",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "RI",
            "license": "MD18287",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MO",
            "license": "2024000213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Creve Coeur, MO

Sources for this page

Verify at the official NPI Registry.