Mitchell Ray Buerck

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2024031307 Issued in MO

Practice address

2937 S Brentwood Blvd
Brentwood, MO 63144-2713

Phone

(314) 961-3804

NPI assigned

Mar 6, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mitchell.buerck.p2@direct.athleticoltd.nextgenshare.com

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.

• Athletico LTD

  • Physical Therapist
  • Liberty, MO
  • NPI 1114449857
  Medicare reassignment Care Compare group NPD
• Athletico LTD

  • Clinic/Center
  • Lafayette, IN
  • NPI 1053044867

  Physical Therapist

  NPD
• Athletico LTD

  • Physical Therapist
  • Oak Brook, IL
  • NPI 1821085028
  NPD

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

{
    "created_epoch": "1551830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723939200000",
    "number": "1992263123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4940 GRANITE DR",
            "city": "SMITHTON",
            "state": "IL",
            "postal_code": "622853635",
            "telephone_number": "618-719-4006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2937 S BRENTWOOD BLVD",
            "city": "BRENTWOOD",
            "state": "MO",
            "postal_code": "631442713",
            "telephone_number": "314-961-3804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUERCK",
        "first_name": "MITCHELL",
        "middle_name": "RAY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-06",
        "last_updated": "2024-08-18",
        "certification_date": "2024-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2024031307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "815976827",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brentwood Adult Daycare
• Brentwood Spine Clinic LLC
• Kenneth Neal Brosh, DDS
• Krista Danielle Brown
• Jennifer Rae Bruner, MA, ATR-BC, NCC
• Eve Bufalo
• Kevin G Buhr, MPT
• Dawn Marie Carey
• Sara Xochitl Carpenter, LPC, PHD
• Heather Colleen Carroll, ATC

• Physical Therapist in Brentwood, MO
• Providers in Brentwood, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.