Active NPI
John P Eldridge, M.D.
- Surgery Physician
- Edgewood, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 23565
- Practice address
- 20 Medical Village Dr
Edgewood, KY 41017-5401 - Phone
- (859) 344-1600
- Fax
- (859) 344-0091
- NPI assigned
- Jun 10, 2006
- Last updated
- Mar 18, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 23565 | KY | Primary |
Addresses
Primary practice location
20 Medical Village Dr
Edgewood, KY 41017-5401
Mailing address
PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 344-1600
Other practice location 1
1500 James Simpson Jr Way
Covington, KY 41011-0801
Phone (859) 655-1100
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000033738 | Other | KY | ANTHEM |
| 0707088 | Medicaid | OH | |
| 0789943 | Other | CIGNA | |
| 64235658 | Medicaid | KY | |
| 020010539 | Other | KY | RAILROAD MEDICARE |
| 4201976 | Other | KY | AETNA |
| 000000747824 | Other | ANTHEM | |
| 3700184 | Other | KY | UNITED HEALTHCARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Other, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
580 S Loop Rd
Edgewood, KY 41017-3415
Phone (859) 344-1600
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.01 of 100
- Quality
- 86.02
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Hernia repair (minimally invasive) | 1-10 |
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 66 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Medical Group, Inc. | Current | Accepting new patients | |
| Summit Medical Group, Inc | Surgery | Current | Accepting new patients |
| Cranley Surgical Associates Inc | Surgery | Past | Accepting new patients |
Locations
606 Wilson Creek Rd
Ste 210
Lawrenceburg, IN 47025
Phone (606) 331-1318
1500 James Simpson Jr Way
Covington, KY 41011
Phone (859) 655-4353
334 Thomas More Pkwy
Crestview Hills, KY 41017
Phone (859) 331-6065
20 Medical Village Dr
Edgewood, KY 41017
Phone (859) 344-1600
20 Medical Village Dr
Ste 338
Edgewood, KY 41017
Phone (606) 341-8202
20 Medical Village Dr
Ste 394
Edgewood, KY 41017
Phone (859) 331-3353
580 S Loop Rd
Edgewood, KY 41017
Phone (859) 301-6000
4900 Houston Rd
Florence, KY 41042
Phone (859) 212-5200
1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700
300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217
Interoperability endpoints
- jeldridge25339@direct-prd.stelizabeth.com
Ownership & related parties
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Emerald Trace | Skilled nursing facility | Corporate Director | May 8, 1993 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
dba Emerald Trace
- Skilled Nursing Facility
- Elsmere, KY
- NPI 1518413889
Corporate Director
Organizations & group practices 3
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.
-
dba St. Elizabeth Physicians
- Family Medicine Physician
- Erlanger, KY
- NPI 1750343216
Surgery
-
dba St. Elizabeth Physicians
- Foot & Ankle Surgery Podiatrist
- Crestview Hills, KY
- NPI 1043188378
-
- Surgery Physician
- Cincinnati, OH
- NPI 1376518845
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba St Elizabeth Grant
- Critical Access Hospital
- Williamstown, KY
- NPI 1114974813
-
- General Acute Care Hospital
- Edgewood, KY
- NPI 1467492421
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552867200000",
"number": "1609817394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 635283",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452635283",
"telephone_number": "859-344-1600",
"fax_number": "859-344-0091"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 MEDICAL VILLAGE DR",
"city": "EDGEWOOD",
"state": "KY",
"postal_code": "410175401",
"telephone_number": "859-344-1600",
"fax_number": "859-344-0091"
}
],
"practiceLocations": [
{
"address_1": "1500 James Simpson Jr Way",
"address_purpose": "LOCATION",
"city": "Covington",
"state": "KY",
"postal_code": "410110801",
"country_code": "US",
"telephone_number": "859-655-1100",
"fax_number": "859-655-1102",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ELDRIDGE",
"first_name": "JOHN",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-10",
"last_updated": "2019-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "KY",
"license": "23565",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000033738",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0707088",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "0789943",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64235658",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "020010539",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4201976",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000747824",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "3700184",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Edgewood, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.