Codyjo Kenneth Kraemer, M.D.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

59231 Issued in AZ

Practice address

5301 E Grant Rd
Tucson, AZ 85712-2805

Phone

(520) 324-5461

Fax

(520) 324-2051

NPI assigned

May 24, 2013

Last updated

Sep 4, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Vascular Surgery

Education

University of Kansas School of Med (KC/Wich/Sal), 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tucson Medical CenterGroup PAC ID 4284527227, 29 clinicians

TMC Medical NetworkGroup PAC ID 9638457013, 276 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tucson Medical Center Hospital, Tucson, AZ, CCN 030006

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cody.kraemer.1@2697.direct.athenahealth.com

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.

• TMC Medical Network

  • Multi-Specialty Clinic/Center
  • Tucson, AZ
  • NPI 1750832283
  Medicare reassignment Care Compare group NPD
• Tucson Medical Center

  • General Acute Care Hospital
  • Tucson, AZ
  • NPI 1174512792
  Medicare reassignment Care Compare group NPD
• Banner-University Medical Group

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1508809427
  Medicare reassignment NPD
• Northern Arizona Healthcare Corporation

  • Family Medicine Physician
  • Flagstaff, AZ
  • NPI 1669914552

  Surgery

  Medicare reassignment NPD
• Pima Heart Physicians, PC

  dba Pima Heart & Vascular

  • Cardiovascular Disease Physician
  • Tucson, AZ
  • NPI 1730137480

  Vascular Surgery

  Medicare reassignment NPD
• Pima Heart Physicians, PC

  dba Pima Heart & Vascular

  • Cardiac Rehabilitation Registered Nurse
  • Sahuarita, AZ
  • NPI 1962259812
  Medicare reassignment NPD
• Banner-University Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Tucson, AZ
  • NPI 1922820935
  NPD
• Northern Arizona Healthcare Corporation

  dba Northern Arizona Healthcare Children's Health Center

  • Multi-Specialty Clinic/Center
  • Flagstaff, AZ
  • NPI 1235732702
  NPD
• Pima Heart Physicians, PC

  dba Pima Heart & Vascular

  • Cardiovascular Disease Physician
  • Sierra Vista, AZ
  • NPI 1003081803

  Vascular Surgery

  NPD
• Tucson Medical Center

  dba Tucson Medical Center Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Tucson, AZ
  • NPI 1972876563
  NPD
• Northwest Neuro Specialists, PLLC

  • Neurological Surgery Physician
  • Tucson, AZ
  • NPI 1619930336
  NPD (past)
• The Univeristy of Arizona

  • General Acute Care Hospital
  • Tucson, AZ
  • NPI 1952740151
  NPD (past)

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

• Tucson Medical Center

  • General Acute Care Hospital
  • Tucson, AZ
  • NPI 1174512792
  Care Compare affiliation

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

{
    "created_epoch": "1369353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1942647425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 E GRANT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122874",
            "telephone_number": "520-324-5461",
            "fax_number": "520-324-2051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 E GRANT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122805",
            "telephone_number": "520-324-5461",
            "fax_number": "520-324-2051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAEMER",
        "first_name": "CODYJO",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-24",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "R73900",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "AZ",
            "license": "59231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Igor Kozak, M.D.
• Kim Amy Kozda
• Marek Koziel, PT DSC
• Kozy Gardens Assisted Living
• Mary Jensen Kracht, DO
• Robert John Kraemer, MA
• Christina Marie Kraft, D.M.D.
• Christine Marie Kraft, LCSW
• Richard Matthew Kralik, DMD
• Delaney Krall

• Vascular Surgery Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Vascular Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.