Individual provider Active NPI

Kathryn Kreicher, MD

  • Otolaryngology Physician
  • Marina del Rey, CA
National Provider Identifier
1407387822
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
A191830 Issued in CA
Practice address
4676 Admiralty Way # 301
Marina del Rey, CA 90292-6601
Phone
(310) 423-1220
NPI assigned
Mar 27, 2017
Last updated
Nov 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Otolaryngology Physician 207Y00000X MD61261440 WA
Otolaryngology Physician 207Y00000X A191830 CA Primary

Addresses

Primary practice location

4676 Admiralty Way # 301
Marina del Rey, CA 90292-6601

Mailing address

4011 Talbot Rd S Ste 210
Renton, WA 98055-5791
Phone (425) 690-3602

Other practice location 1

263 Farmington Ave
Farmington, CT 06030-1921
Phone (203) 273-6539

Other practice location 2

4011 Talbot Rd S Ste 210
Renton, WA 98055-5791
Phone (425) 690-3602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20231116001775 CA Practitioner - Otolaryngology 5395017586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cedars-Sinai Medical Care FoundationGroup PAC ID 0941106645, 1,684 clinicians

Practice addresses (Care Compare)

4676 Admiralty Way
FL 4
Marina del Rey, CA 90292-6601
Phone (310) 423-4933

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A191830CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Care Foundation CurrentSince Nov 6, 2023 Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients

Locations

8631 W 3rd St
#1140E
Los Angeles, CA 90048
Phone (310) 203-0222

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

4676 Admiralty Way
Fl 4
Marina del Rey, CA 90292
Phone (310) 306-6966

4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780

Interoperability endpoints

  • Direct secure messaging: kkreicher453450@direct.cshs.org
  • Direct secure messaging: kkreicher98681@direct.valleymed.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1407387822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4011 TALBOT RD S STE 210",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555791",
            "telephone_number": "425-690-3602",
            "fax_number": "425-690-9602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4676 ADMIRALTY WAY # 301",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926601",
            "telephone_number": "310-423-1220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "263 Farmington Ave",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "060301921",
            "country_code": "US",
            "telephone_number": "203-273-6539",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4011 Talbot Rd S Ste 210",
            "address_purpose": "LOCATION",
            "city": "Renton",
            "state": "WA",
            "postal_code": "980555791",
            "country_code": "US",
            "telephone_number": "425-690-3602",
            "fax_number": "425-690-9602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KREICHER",
        "first_name": "KATHRYN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-27",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WA",
            "license": "MD61261440",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A191830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marina del Rey, CA

Sources for this page

Verify at the official NPI Registry.