Jonathan Cremin, MD
Individual provider Active NPI Anesthesiology Physician · Wichita, KS
NPI 1922079920 · NPPES record last updated Jan 14, 2014
Key facts
- NPI
- 1922079920
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- 04-30813 (KS)
- Practice address
- 550 N Hillside St
Wichita, KS 67214-4910 - Phone
- (316) 789-8444
- Fax
- (316) 652-0340
- NPI assigned
- Jan 28, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Anesthesiology
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mid-Continent Anesthesiology Chartered
Practice addresses (Care Compare)
550 N Hillside St
Wichita, KS 67214-4910
Phone (316) 789-8444
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- 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 |
|---|---|---|---|---|
| I20050125000767 | KS | Practitioner - Anesthesiology | 8224088570 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04-30813 | KS | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mid-Continent Anesthesiology Chartered | Anesthesiology | Current |
Accepting new patients |
Locations
550 N Hillside St
Wichita, KS 67214
Phone (316) 688-2239
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 04-30813 | KS | Yes |
Addresses
Primary practice location
550 N Hillside St
Wichita, KS 67214-4910
Mailing address
PO Box 47890
Wichita, KS 67201-7890
Phone (316) 685-6112
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200304050B | Medicaid | KS | |
| 200056100A | Medicaid | OK | |
| 104735 | Other | KS | BCBS |
Other providers in Wichita, KS
- Creating Miracles LLC
- Creative Bliss Therapy
- Emily Creed
- Heather Creed
- Michele Creger
- Linda R Crenshaw
- December T Crew
- Natalie Crist
- Renee E Cristiano
- Braedan Spencer Crites
All providers in Wichita, KS · Anesthesiology Physician in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 2014. 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.