Active NPI
Marcie Kroska, PA-C
- Physician Assistant
- Bradenton, FL
National Provider Identifier
1003883067
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9108805
- Practice address
- 206 2ND St E
Bradenton, FL 34208-1042 - Phone
- (941) 746-5111
- Fax
- (941) 745-7233
- NPI assigned
- Mar 8, 2006
- Last updated
- Sep 20, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9108805 | FL | Primary |
| Physician Assistant | 363A00000X | 5601001892 | MI |
Addresses
Primary practice location
206 2ND St E
Bradenton, FL 34208-1042
Mailing address
367 S. Gulph Rd
Attn: Ipm Credentialing
King of Prussia, PA 19406-3121
Phone (941) 746-5111
Other practice location 1
44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-5000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9108805 | FL | MD | Physician Assistant |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537401600000",
"number": "1003883067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "367 S. GULPH RD",
"address_2": "ATTN: IPM CREDENTIALING",
"city": "KING OF PRUSSIA",
"state": "PA",
"postal_code": "194063121",
"telephone_number": "941-746-5111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "206 2ND ST E",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342081042",
"telephone_number": "941-746-5111",
"fax_number": "941-745-7233"
}
],
"practiceLocations": [
{
"address_1": "44201 Dequindre Rd",
"address_purpose": "LOCATION",
"city": "Troy",
"state": "MI",
"postal_code": "480851117",
"country_code": "US",
"telephone_number": "248-964-5000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KROSKA",
"first_name": "MARCIE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-08",
"last_updated": "2018-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9108805",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601001892",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bradenton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.