Timothy S Kristedja, MD

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

A108522 Issued in CA

Practice address

2001 Santa Monica Blvd Ste 560W
Santa Monica, CA 90404-2182

Phone

(310) 453-5654

Fax

(310) 453-6885

NPI assigned

Jun 9, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Hematology/Oncology

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Saint Johns Medical FoundationGroup PAC ID 0840548624, 282 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint John'S Health Center Hospital, Santa Monica, CA, CCN 050290

Merit-based Incentive Payment System (MIPS)

Final score

90.42 of 100Reported as group

Quality

96.07

Promoting interoperability

100

Improvement activities

40

Cost

71.98

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: tkristedja405655@oc.providencedirect.org

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.

• Providence Saint Johns Medical Foundation

  • Specialist
  • Santa Monica, CA
  • NPI 1770093734
  Medicare reassignment Care Compare group NPD
• County of Los Angeles

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1851363188
  Medicare reassignment
• Cedars-Sinai Marina Hospital

  • General Acute Care Hospital
  • Marina del Rey, CA
  • NPI 1942269725
  NPD (past)
• Cedars-Sinai Medical Center

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1639172372
  NPD (past)
• Providence Health System Southern California

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1902844988
  NPD (past)
• Providence Saint John'S Health Center

  • General Acute Care Hospital
  • Santa Monica, CA
  • NPI 1124026273
  NPD (past)
• Torrance Memorial Medical Center

  • Skilled Nursing Facility
  • Torrance, CA
  • NPI 1740268713
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Saint John'S Health Center

  • General Acute Care Hospital
  • Santa Monica, CA
  • NPI 1124026273
  Care Compare affiliation

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

{
    "created_epoch": "1181347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1881897494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2477 WALNUT AVE",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902915018",
            "telephone_number": "626-367-2824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 SANTA MONICA BLVD STE 560W",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042182",
            "telephone_number": "310-453-5654",
            "fax_number": "310-453-6885"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2021 Santa Monica Blvd Ste 400E",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904042103",
            "country_code": "US",
            "telephone_number": "310-453-5654",
            "fax_number": "310-453-6885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRISTEDJA",
        "first_name": "TIMOTHY",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-09",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "A108522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tkristedja405655@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2021 Santa Monica Blvd Ste 400E",
            "city": "Santa Monica",
            "state": "CA",
            "country_code": "US",
            "postal_code": "904042103",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tkristedja405655@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "12555 W Jefferson Blvd Ste 303",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900667032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ashley Amber Kreger, PT
• Jennifer Marie Krekel, DPT
• Vinciane Krepper, L.AC
• Kimberly Krieger
• Milton Krisiloff, MD
• Michael A Kropf, M.D.
• Erica Krusen, MFT INTERN
• Allen R Kubko, FNP-C
• Stephen Louis Kuchenbecker
• Jordan Grace Kuchta

• Hematology & Oncology Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Hematology & Oncology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.

Verify at the official NPI Registry.