Individual provider Active NPI

Peter K Kriz, MD

  • Pediatric Sports Medicine Physician
  • Boston, MA
National Provider Identifier
1881681310
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Sports Medicine PhysicianTaxonomy code 2080S0010X
License
238310 Issued in MA
Practice address
300 Longwood Ave
Boston, MA 02115-5724
Phone
(617) 355-6000
NPI assigned
Sep 30, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Sports Medicine Physician 2080S0010X 238310 MA Primary
Pediatric Sports Medicine Physician 2080S0010X 10239 RI

Addresses

Primary practice location

300 Longwood Ave
Boston, MA 02115-5724

Mailing address

300 Longwood Ave
Boston, MA 02115-5724
Phone (617) 355-6000

Other practice location 1

2 Dudley St
Suite 200
Providence, RI 02905-3236
Phone (401) 457-2188

Other identifiers 1

IdentifierTypeStateIssuer
PK50725MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050412001077 RI Practitioner - Pediatric MedicinePractitioner - Sports Medicine 1759328636 Reassigns benefits to 1 organization
I20230829001991 MA Practitioner - Sports Medicine 1759328636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports Medicine
Education
Tufts University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Children'S Sports Medicine Foundation IncGroup PAC ID 7719901198, 34 clinicians

Practice addresses (Care Compare)

300 Longwood Ave
Boston, MA 02115-5724
Phone (617) 355-6000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10239RIMDPediatric Sports Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Orthopedics, Inc. CurrentSince Jul 1, 2012 Accepting new patients
Children'S Sports Medicine Foundation Inc. Sports Medicine CurrentSince Aug 14, 2023 Accepting new patients
University Orthopedics, Inc. CurrentSince Jul 1, 2012 Accepting new patients

Locations

300 Longwood Ave
Boston, MA 02115
Phone (617) 355-4956

2 Dudley St
Ste 200
Providence, RI 02905
Phone (401) 457-1504

593 Eddy St
Providence, RI 02903

Interoperability endpoints

  • Direct secure messaging: pkriz22436@direct.bostonchildrens.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1881681310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Dudley St",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029053236",
            "country_code": "US",
            "telephone_number": "401-457-2188",
            "fax_number": "401-457-2187",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRIZ",
        "first_name": "PETER",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "MA",
            "license": "238310",
            "primary": true
        },
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "RI",
            "license": "10239",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PK50725",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.