Robert Allan Gjertson, DPM
Individual provider Active NPI Primary Podiatric Medicine Podiatrist · Oveland Park, KS
NPI 1992701544 · NPPES record last updated Apr 4, 2014
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Mar 20, 2018.
Key facts
- NPI
- 1992701544
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Primary Podiatric Medicine Podiatrist 213EP1101X
- License
- 566 (MN)
- Practice address
- 6715 W 126TH Place
Oveland Park, KS 66209-3230 - Phone
- (651) 402-3558
- NPI assigned
- Jun 27, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 566 | MN | MD | Midwife |
| 12-00393 | KS | MD | Primary Podiatric Medicine Podiatrist |
| 2012013991 | MO | MD | Primary Podiatric Medicine Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maplewood Podiatry, LLC | Past | Accepting new patients | |
| Christopher Weis | Past | Accepting new patients | |
| Associated Podiatrists, P.C. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Podiatric Medicine Podiatrist | 213EP1101X | 566 | MN | Yes |
| Primary Podiatric Medicine Podiatrist | 213EP1101X | 2012013991 | MO | |
| Primary Podiatric Medicine Podiatrist | 213EP1101X | 12-00393 | KS | |
| Foot Surgery Podiatrist | 213ES0131X | 566 | MN |
Addresses
Primary practice location
6715 W 126TH Place
Oveland Park, KS 66209-3230
Mailing address
6715 W 126TH Place
Oveland Park, KS 66209-3230
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 971371012008 | Other | MN | PREFERREDONE |
| 21250174910 | Other | MN | BEECHSTREET |
| 465TOGJ | Other | MN | BCBS OF MN |
| 27-00450 | Other | MN | MEDICA |
| P00141474 | Other | MN | RAILROAD MEDICARE |
| 278018600 | Medicaid | MN | |
| 686485 | Other | MN | AMERICA'S PPO |
| 114036 | Other | MN | UCARE |
| 5836442 | Other | MN | AETNA |
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 4, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- OIG LEIE (HHS Office of Inspector General).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.