Kevin S Goeta Kreisler, MD
Individual provider Active NPI Specialist · Tucson, AZ
NPI 1801969076 · NPPES record last updated May 26, 2023
Key facts
- NPI
- 1801969076
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 22102 (AZ)
- Practice address
- 6408 E Tanque Verde Rd
Tucson, AZ 85715 - Phone
- (520) 885-5558
- Fax
- (520) 885-5559
- NPI assigned
- Nov 16, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Psychiatry
- Education
- University of Nevada, Las Vegas School of Medicine, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Aleph Center, P.L.L.C.
Accumen TMS Center
Practice addresses (Care Compare)
6408 E Tanque Verde Rd
Tucson, AZ 85715-3809
Phone (520) 885-5558
7840 Imperial Hwy
Suite B
Downey, CA 90242-3457
Phone (213) 784-7918
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AZ, CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110628000785 | AZ | Practitioner - Psychiatry |
2668497546 | Reassigns benefits to 1 organization |
| I20221115003434 | CA | Practitioner - Psychiatry | 2668497546 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22102 | AZ | MD | Specialist |
| G169187 | CA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Accumen TMS Center | Psychiatry | Current |
Accepting new patients |
| Aleph Center, P.L.L.C. | Psychiatry | Current |
Accepting new patients |
Locations
6408 E Tanque Verde Rd
Tucson, AZ 85715
Phone (520) 885-5558
7840 Imperial Hwy
#B
Downey, CA 90242
Phone (213) 784-7918
1300 N Vermont Ave
Los Angeles, CA 90027
Phone (213) 413-3000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | G169187 | CA | |
| Specialist | 174400000X | 22102 | AZ | Yes |
Addresses
Primary practice location
6408 E Tanque Verde Rd
Tucson, AZ 85715
Mailing address
6408 E Tanque Verde Rd
Tucson, AZ 85715
Phone (520) 885-5558
Other practice location 1
1300 N. Vermot Ave
Los Angeles, CA 90027
Phone (213) 413-3000
Other practice location 2
12381 Wilshire Blvd Ste 205
Los Angeles, CA 90025-1063
Phone (833) 867-2329
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16381602 | Medicaid | AZ |
Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 26, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.