Dmitriy Kedrin, M.D. PH.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

17627 Issued in NH

Practice address

185 Queen City Ave
Elliot Gastroenterology
Manchester, NH 03101-7121

Phone

(603) 314-6900

NPI assigned

Jun 18, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NH

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

Specialty

Gastroenterology

Education

Albert Einstein College of Medicine of Yeshiva University, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Elliot Professional ServicesGroup PAC ID 6103727920, 429 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elliot Hospital Hospital, Manchester, NH, CCN 300012

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

Practice roles

Locations

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.

• Elliot Professional Services

  • Internal Medicine Physician
  • Manchester, NH
  • NPI 1285627935
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Elliot Hospital of the City of Manchester

  • General Acute Care Hospital
  • Manchester, NH
  • NPI 1902996028
  Care Compare affiliation

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

{
    "created_epoch": "1276819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465948800000",
    "number": "1235450792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 QUEEN CITY AVE",
            "address_2": "ELLIOT GASTROENTEROLOGY",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031017121",
            "telephone_number": "603-314-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 QUEEN CITY AVE",
            "address_2": "ELLIOT GASTROENTEROLOGY",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031017121",
            "telephone_number": "603-314-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEDRIN",
        "first_name": "DMITRIY",
        "name_prefix": "Dr.",
        "credential": "M.D. PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-18",
        "last_updated": "2016-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NH",
            "license": "17627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kondwani Kayira
• Elizabeth M Keane, MD
• Melissa Ann Keaney, PA-C
• Christa Keddie, RDH, CPHDH
• Sarah M Keddie
• Kevin Michael Keefe Jr., LICSW
• Kristin Ann Keefe, M.D.
• Lisa M Keefe, RN
• Brenton Keele
• Katherine Ellen Keener, NNP

• Gastroenterology Physician in Manchester, NH
• Providers in Manchester, NH by specialty
• Gastroenterology Physician in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2016; 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.

Verify at the official NPI Registry.