Michael Raethka (NPI# 1033109392, PAC ID# 2365756103) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1033109392 |
| PAC ID by PECOS | 2365756103 |
| Professional Enrollment ID | I20150806011364 |
| Full Name | Michael Raethka |
| Organization Legal Name | MERCY CLINIC SURGICAL SPECIALISTS LLC |
| Address |
1390 Us Hwy 61 Suite N1500 Festus MO 63028-4137 |
| Gender | M |
| Medical School | UNIV OF NEBRASKA MEDICAL CENTER, COL OF DENTISTRY |
| Graduation Year | 2003 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 1153455076 |
| Number of Group Practice Members | 50 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 260023 | MERCY HOSPITAL JEFFERSON |
| Address | Phone | Organization |
|---|---|---|
| 1390 Us Hwy 61, Suite N1500, Festus, MO 63028-4137 | MERCY CLINIC SURGICAL SPECIALISTS LLC | |
| 1390 Us Hwy 61 N1500, Mercy Clinic Vascular Specialist J, Festus, MO 63028-4137 | MERCY CLINIC SURGICAL SPECIALISTS LLC | |
| 621 S New Ballas Rd, Suite 3005b, Saint Louis, MO 63141-8266 | 3145675850 | MERCY CLINIC SURGICAL SPECIALISTS LLC |
| 621 S New Ballas Rd, Suite 7011b, Saint Louis, MO 63141-8275 | 3142516840 | MERCY CLINIC SURGICAL SPECIALISTS LLC |
| Organization Legal Name | MERCY CLINIC SURGICAL SPECIALISTS LLC |
| Physicians | 50 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tatiana Ramirez Dominguez | General Surgery | Mercy Clinic Surgical Specialists LLC | 621 S New Ballas Rd, Suite 7011b, Saint Louis, MO 63141-8275 |
| Sarah E Kessen | Nurse Practitioner | Mercy Clinic Surgical Specialists LLC | 15945 Clayton Rd, Suite 210, Ballwin, MO 63011-2490 |
| Matthew A Lange | General Surgery | Mercy Clinic Surgical Specialists LLC | 621 S New Ballas Rd, Suite 7011b, Saint Louis, MO 63141-8275 |
| Keith J Odegard | Orthopedic Surgery | Mercy Clinic Surgical Specialists LLC | 10777 Sunset Office Dr, Suite 120, Saint Louis, MO 63127-1019 |
| Patricia A Limpert | General Surgery | Mercy Clinic Surgical Specialists LLC | 851 E 5th St, Suite 108, Washington, MO 63090-3128 |
| Sekhar Dharmarajan | General Surgery | Mercy Clinic Surgical Specialists LLC | 621 S New Ballas Rd, Suite 7011b, Saint Louis, MO 63141-8275 |
| James Strickland | Orthopedic Surgery | Mercy Clinic Surgical Specialists LLC | 621 S New Ballas Rd, Suite 3005b, Saint Louis, MO 63141-8266 |
| Gregory R Galakatos | Orthopedic Surgery | Mercy Clinic Surgical Specialists LLC | 621 S New Ballas Rd, Suite 3005b, Saint Louis, MO 63141-8266 |
| Husam T Nawas | Orthopedic Surgery | Mercy Clinic Surgical Specialists LLC | 15945 Clayton Rd, Suite 210, Ballwin, MO 63011-2490 |
| Jeffrey K Jenks | Orthopedic Surgery | Mercy Clinic Surgical Specialists LLC | 1390 Us Hwy 61, Suite N1500, Festus, MO 63028-4137 |
| Street Address |
1390 US HWY 61 SUITE N1500 |
| City | FESTUS |
| State | MO |
| Zip | 63028-4137 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jeffrey K Jenks | Orthopedic Surgery | Mercy Clinic Surgical Specialists LLC | 1390 Us Hwy 61, Suite N1500, Festus, MO 63028-4137 |
| Gregg A Ginsburg | General Surgery | Mercy Clinic Surgical Specialists LLC | 1390 Us Hwy 61, Suite N1500, Festus, MO 63028-4137 |
| Christopher M Speidel | Interventional Cardiology | Physician Groups Lc | 1390 Us Hwy 61, Suite 2300, Festus, MO 63028-4121 |
| Paul R Maynard | Orthopedic Surgery | Mercy Clinic Surgical Specialists LLC | 1390 Us Hwy 61, Suite N1500, Festus, MO 63028-4137 |
| Angela M Ware | Internal Medicine | Mercy Clinic Surgical Specialists LLC | 1390 Us Hwy 61, Suite N1500, Festus, MO 63028-4137 |
| Sushruth Edla | Cardiovascular Disease (cardiology) | Mercy Clinic Heart and Vascular LLC | 1390 Us Hwy 61, Suite N1500, Festus, MO 63028-4137 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sarah L Jensen | Dermatology | 1463 Hwy 61 B, Festus, MO 63028 | |
| Chandra B Dommaraju | Infectious Disease | 1400 Hwy 61 240b, Festus, MO 63028 | |
| Robert J Evens | Emergency Medicine | Southeastern Emergency Physicians of Memphis LLC | 1400 Hwy 61 S, Festus, MO 63028 |
| Paul H Wang | Psychologist, Clinical | 1400 Hwy 61 S, Festus, MO 63028 | |
| Kevin T Baumgartner | Emergency Medicine | Southeastern Emergency Physicians of Memphis LLC | 1400 Hwy 61 S, Festus, MO 63028 |
| Phillip J Ward | Physical Therapy | Central Missouri Physical Therapy LLC | 1405 N Truman Blvd, Festus, MO 63028-1177 |
| Ashley P Schwendeman | Physical Therapy | Central Missouri Physical Therapy LLC | 1405 N Truman Blvd, Festus, MO 63028-1177 |
| Mindy Kay Wortmann | Nurse Practitioner | Interventional Pain Institute, LLC | 1405 N Truman Blvd, Festus, MO 63028-1177 |
| Steven A Harvey | Psychiatry | 23 N 6th St, My Place Residential Facility, Festus, MO 63028-1301 | |
| William W Clendenin | Psychiatry | 705 Moore St, Festus, MO 63028-1339 | |
| Find all physicians in zip 63028 | |||
| City | FESTUS |
| Zip Code | 63028 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | FESTUS + PHYSICIAN ASSISTANT |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.