Individual provider Active NPI

Evgeniy Kreydin, MD

  • Urology Physician
  • Los Angeles, CA
National Provider Identifier
1386870889
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
A133167 Issued in CA
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

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

TypeEndpointUseAffiliation
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, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140516001144 MA Practitioner - Urology 2466619713 Reassigns benefits to 2 organizations
I20170601002421 CA Practitioner - Urology 2466619713 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A133167CAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Nov 1, 2014 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Nov 1, 2014 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Nov 1, 2014 Accepting new patients
Usc Care Medical Group, Inc Urology CurrentSince Jun 1, 2017 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Urology CurrentSince Nov 1, 2014 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Jun 1, 2017 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.