Active NPI
Charles J Eldredge, M.D.
- Nephrology Physician
- Utica, NY
National Provider Identifier
1215989322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 165839
- Practice address
- 125 Business Park Dr Ste 150
Utica, NY 13502-6322 - Phone
- (315) 735-3541
- Fax
- (315) 724-3255
- NPI assigned
- May 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 165839 | NY | |
| Nephrology Physician | 207RN0300X | 165839 | NY | Primary |
Addresses
Primary practice location
125 Business Park Dr Ste 150
Utica, NY 13502-6322
Mailing address
125 Business Park Dr Ste 150
Utica, NY 13502-6322
Phone (315) 735-3541
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01070199 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nephrology
- Education
- State University of New York at Stony Brook, School of Medicine, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
125 Business Park Dr
Suite 150
Utica, NY 13502-6322
Phone (315) 735-3541
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 165839 | NY | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mohawk Valley Nephrology Associates, LLP | Internal Medicine | Current | Accepting new patients |
Locations
555 French Rd
Ste 103
New Hartford, NY 13413
Phone (315) 624-7500
125 Business Park Dr
Ste 150
Utica, NY 13502
Phone (315) 235-2540
Organizations & group practices 1
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.
-
- Nephrology Physician
- Utica, NY
- NPI 1548287329
Internal Medicine
Hospital & facility affiliations 16
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Utica, NY
- NPI 1336881713
Dialysis facility
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Rome, NY
- NPI 1164165304
Dialysis facility
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Oneida, NY
- NPI 1629711882
Dialysis facility
-
- Critical Access Hospital
- Little Falls, NY
- NPI 1558321919
-
- Rural Acute Care Hospital
- Cooperstown, NY
- NPI 1780600577
-
- General Acute Care Hospital
- Utica, NY
- NPI 1205877172
-
- General Acute Care Hospital
- Oneida, NY
- NPI 1962408203
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Rome, NY
- NPI 1306807193
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725580800000",
"number": "1215989322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 BUSINESS PARK DR STE 150",
"city": "UTICA",
"state": "NY",
"postal_code": "135026322",
"telephone_number": "315-735-3541",
"fax_number": "315-724-3255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 BUSINESS PARK DR STE 150",
"city": "UTICA",
"state": "NY",
"postal_code": "135026322",
"telephone_number": "315-735-3541",
"fax_number": "315-724-3255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELDREDGE",
"first_name": "CHARLES",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-17",
"last_updated": "2024-09-06",
"certification_date": "2024-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "165839",
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "NY",
"license": "165839",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01070199",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Utica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.