Individual provider Active NPI

John P Eldridge, M.D.

  • Surgery Physician
  • Edgewood, KY
National Provider Identifier
1609817394
Registry record updated Mar 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
23565 Issued in KY
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, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
000000033738OtherKYANTHEM
0707088MedicaidOH
0789943OtherCIGNA
64235658MedicaidKY
020010539OtherKYRAILROAD MEDICARE
4201976OtherKYAETNA
000000747824OtherANTHEM
3700184OtherKYUNITED 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100225000303 KY Practitioner - General Surgery 3274676135 Reassigns benefits to 1 organization

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
Summit Medical Group IncGroup PAC ID 2163326240, 803 clinicians

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 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue66
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc. CurrentSince Oct 13, 2016 Accepting new patients
Summit Medical Group, Inc Surgery CurrentSince Oct 13, 2016 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

  • Direct secure messaging: 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.

FacilityTypeRoleSince
Emerald TraceElsmere, KY, CCN 185481 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.

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.

Hospital & facility affiliations 2

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": "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

Verify at the official NPI Registry.