Individual provider Active NPI

Geoffrey N. Kredich, M.D.

  • Anesthesiology Physician
  • Iowa City, IA
National Provider Identifier
1467650994
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
R8123 Issued in IA
Practice address
200 Hawkins Dr
Iowa City, IA 52242-1009
Phone
(319) 356-2256
NPI assigned
Jul 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X R8123 IA Primary

Addresses

Primary practice location

200 Hawkins Dr
Iowa City, IA 52242-1009

Mailing address

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-2256

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20151108000004 SC Practitioner - Anesthesiology 5496065237 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of South Carolina School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Anesthesia Associates LLCGroup PAC ID 9032022744, 16 clinicians
Trident Anesthesia Group LLCGroup PAC ID 5294631545, 121 clinicians

Practice addresses (Care Compare)

130 Edge St
Summerville, SC 29486-3002
Phone (843) 764-0992

295 Midland Pkwy
Summerville, SC 29485-8104
Phone (843) 832-5000

9313 Medical Plaza Dr
Suite 102
Charleston, SC 29406-9153
Phone (843) 797-8992

9330 Medical Plaza Dr
Charleston, SC 29406-9104
Phone (843) 797-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R8123IAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Palmetto Anesthesia of Charleston, LLC Anesthesiology CurrentSince Feb 6, 2017 Accepting new patients
Trident Anesthesia Group, LLC Anesthesiology CurrentSince Feb 6, 2017 Accepting new patients
Palmetto Digestive Disease PA CurrentSince Dec 1, 2017 Accepting new patients
Coastal Anesthesia Associates, LLC Anesthesiology CurrentSince Feb 1, 2018 Accepting new patients

Locations

1962 Charlie Hall Blvd
Charleston, SC 29414
Phone (803) 722-8000

2073 Charlie Hall Blvd
Charleston, SC 29414
Phone (843) 571-0643

423 Barony St
Moncks Corner, SC 29461

9313 Medical Plaza Dr
Ste 102
North Charleston, SC 29406
Phone (843) 572-1228

9263 Medical Plaza Dr
Ste E
North Charleston, SC 29406
Phone (843) 572-1228

130 Edge St
Summerville, SC 29486
Phone (843) 628-5816

Organizations & group practices 4

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": "1183593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467650994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-2256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-2256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREDICH",
        "first_name": "GEOFFREY",
        "middle_name": "N.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IA",
            "license": "R8123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.