Active NPI
Evgeniy Kreydin, MD
- Urology Physician
- Los Angeles, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- A133167
- Practice address
- 1516 San Pablo St FL 5
Los Angeles, CA 90033-5313 - Phone
- (323) 865-3700
- NPI assigned
- Jun 10, 2009
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician | 207VF0040X | 01094143A | IN | |
| Urology Physician | 208800000X | 01094143A | IN | |
| Urology Physician | 208800000X | A133167 | CA | Primary |
Addresses
Primary practice location
1516 San Pablo St FL 5
Los Angeles, CA 90033-5313
Mailing address
PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 865-3700
Other practice location 1
5165 McCarty Ln
Lafayette, IN 47905-8764
Phone (765) 448-8000
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | evgeniy.kreydin@direct.usc.edu | Direct | USC CARE MEDICAL GROUP, INC |
| Direct Messaging Address | ekreydin@direct.iuhealth.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A133167 | CA | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beth Israel Deaconess Medical Center, Inc. | Current | Accepting new patients | |
| Beth Israel Deaconess Medical Center, Inc. | Current | Accepting new patients | |
| Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc | Current | Accepting new patients | |
| Usc Care Medical Group, Inc | Urology | Current | Accepting new patients |
| Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc | Urology | Current | Accepting new patients |
| Usc Care Medical Group, Inc | Current | Accepting new patients |
Locations
125 W Huntington Dr
Bldg B
Arcadia, CA 91007
Phone (626) 281-8288
420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647
1818 Verdugo Blvd
Ste 318
Glendale, CA 91208
1808 Verdugo Blvd
Ste 318
Glendale, CA 91208
Phone (818) 790-1278
1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849
1441 Eastlake Ave
Ste 7416
Los Angeles, CA 90089
Phone (323) 865-3700
1520 San Pablo St
Ste 3800
Los Angeles, CA 90033
Phone (323) 442-5720
1516 San Pablo St
Fl 5
Los Angeles, CA 90033
Phone (323) 276-3707
1516 San Pablo St
Los Angeles, CA 90033
Phone (323) 276-3705
330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000
46 Obery St
Plymouth, MA 02360
Phone (508) 210-5920
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- ekreydin@direct.iuhealth.org
Organizations & group practices 6
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.
-
- General Acute Care Hospital
- Boston, MA
- NPI 1548202641
-
- Surgery Physician
- Boston, MA
- NPI 1720037385
Urology
-
- Durable Medical Equipment & Medical Supplies
- Pasadena, CA
- NPI 1427937390
-
- Ambulance
- Boston, MA
- NPI 1518600501
-
- Emergency Medicine Physician
- Boston, MA
- NPI 1316987993
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730246400000",
"number": "1386870889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 31309",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900310309",
"telephone_number": "323-865-3700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1516 SAN PABLO ST FL 5",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900335313",
"telephone_number": "323-865-3700"
}
],
"practiceLocations": [
{
"address_1": "5165 McCarty Ln",
"address_purpose": "LOCATION",
"city": "Lafayette",
"state": "IN",
"postal_code": "479058764",
"country_code": "US",
"telephone_number": "765-448-8000",
"fax_number": "765-448-7619",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KREYDIN",
"first_name": "EVGENIY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-10",
"last_updated": "2024-10-30",
"certification_date": "2024-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "207VF0040X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
"state": "IN",
"license": "01094143A",
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "IN",
"license": "01094143A",
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "CA",
"license": "A133167",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "evgeniy.kreydin@direct.usc.edu",
"affiliation": "Y",
"affiliationName": "USC CARE MEDICAL GROUP, INC",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1516 San Pablo St Fl 5",
"city": "Los Angeles",
"state": "CA",
"country_code": "US",
"postal_code": "900335313",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ekreydin@direct.iuhealth.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "5165 McCarty Ln",
"city": "Lafayette",
"state": "IN",
"country_code": "US",
"postal_code": "479058764",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.