Individual provider Active NPI

Kenneth Edward Redcross, M.D.

  • Internal Medicine Physician
  • Eastchester, NY
National Provider Identifier
1396757571
Registry record updated Dec 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
219349 Issued in NY
Practice address
475 White Plains Rd Ste 14
Eastchester, NY 10709-5537
Phone
(914) 337-4445
NPI assigned
Aug 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 219349 NY Primary

Addresses

Primary practice location

475 White Plains Rd Ste 14
Eastchester, NY 10709-5537

Mailing address

189 Storer Ave
New Rochelle, NY 10801-3133
Phone (818) 633-1556

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100630000539 NY Practitioner - Internal Medicine 2668498502 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Virginia Commonwealth University, School of Medicine, 1998
Medicare assignment
May accept Medicare assignment
Group practices
Select PT, OT and SLP Rehabilitation Ny, PLLCGroup PAC ID 3870986656, 261 clinicians
Housecalls Medicine Ny PCGroup PAC ID 7517358054, 31 clinicians

Practice addresses (Care Compare)

125 Harry Howard Ave
Hudson, NY 12534-1601
Phone (800) 479-7695

5 Penn PLZ
FL 23
New York, NY 10001-1810
Phone (718) 360-9370

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
219349NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lyons Medical Care, PLLC Internal Medicine CurrentSince Sep 1, 2014 Accepting new patients
Medi-Stop, Inc. Past Accepting new patients

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.

Hospital & facility affiliations 3

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": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418601600000",
    "number": "1396757571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 STORER AVE",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108013133",
            "telephone_number": "818-633-1556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 WHITE PLAINS RD STE 14",
            "city": "EASTCHESTER",
            "state": "NY",
            "postal_code": "107095537",
            "telephone_number": "914-337-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDCROSS",
        "first_name": "KENNETH",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2014-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "219349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eastchester, NY

Sources for this page

Verify at the official NPI Registry.