Individual provider Active NPI

Marcene Faye Kreifels, M.D.

  • Family Medicine Physician
  • Crestview, FL
National Provider Identifier
1801905039
Registry record updated Oct 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
50036 Issued in FL
Practice address
1198 S Ferdon Blvd
Crestview, FL 32536-4512
Phone
(850) 682-1735
Fax
(850) 689-4400
NPI assigned
Aug 30, 2006
Last updated
Oct 22, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 50036 FL Primary

Addresses

Primary practice location

1198 S Ferdon Blvd
Crestview, FL 32536-4512

Mailing address

1198 S Ferdon Blvd
Crestview, FL 32536-4512
Phone (850) 682-1735

Other identifiers 2

IdentifierTypeStateIssuer
045005700MedicaidFL
230000426OtherRRB PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20110629000289 FL Practitioner - General PracticePractitioner - General Surgery 5496933129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: General Surgery
Education
Creighton University School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1198 S Ferdon Blvd
Crestview, FL 32536-4512
Phone (850) 682-1735

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50036FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marcene F. Kreifels, M.D., P.a. CurrentSince Jan 13, 1997 Accepting new patients

Locations

1198 S Ferdon Blvd
Crestview, FL 32536
Phone (850) 682-1098

938 Freeport Hwy S
Defuniak Springs, FL 32435
Phone (850) 892-2266

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193011200000",
    "number": "1801905039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1198 S FERDON BLVD",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325364512",
            "telephone_number": "850-682-1735",
            "fax_number": "850-689-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1198 S FERDON BLVD",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325364512",
            "telephone_number": "850-682-1735",
            "fax_number": "850-689-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREIFELS",
        "first_name": "MARCENE",
        "middle_name": "FAYE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "50036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "045005700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRB PTAN",
            "identifier": "230000426",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview, FL

Sources for this page

Verify at the official NPI Registry.