Individual provider Active NPI

Kevin Friedrich, MD

  • Surgery Physician
  • Cumming, GA
National Provider Identifier
1295232106
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
99450 Issued in GA
Practice address
980 Sanders Rd Ste 100
Cumming, GA 30041-5977
Phone
(770) 886-1074
NPI assigned
Apr 7, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X 99450 GA Primary

Addresses

Primary practice location

980 Sanders Rd Ste 100
Cumming, GA 30041-5977

Mailing address

1442 Edenham LN
Cumming, GA 30041-7085

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20241030002309 GA Practitioner - General Surgery 7416207220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Medical College of Georgia School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians

Practice addresses (Care Compare)

980 Sanders Rd
Suite 100
Cumming, GA 30041-5977
Phone (770) 866-1074

Hospital & facility affiliations

  • Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)15
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
99450GAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Surgical Professional Services LLC Surgery CurrentSince Sep 1, 2024 Accepting new patients

Locations

4700 Nelson Brogdon Blvd
Ste 125
Buford, GA 30518
Phone (470) 242-0725

980 Sanders Rd
Ste 100
Cumming, GA 30041
Phone (770) 866-1074

134 Ansley Dr
Ste 200
Dahlonega, GA 30533
Phone (706) 864-2155

81 Northside Dawson Dr
Ste 315
Dawsonville, GA 30534
Phone (770) 601-9440

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

3340 Paddocks Pkwy
Suwanee, GA 30024
Phone (678) 474-9633

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1523059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1295232106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1442 EDENHAM LN",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 SANDERS RD STE 100",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300415977",
            "telephone_number": "770-886-1074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDRICH",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-07",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "99450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.