Individual provider Active NPI

Michael D Krak, M.D.

  • Pediatrics Physician
  • Vista, CA
National Provider Identifier
1003989419
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G41229 Issued in CA
Practice address
2067 W Vista Way Ste 280
Vista, CA 92083-6034
Phone
(760) 941-3630
Fax
(760) 941-1214
NPI assigned
Nov 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X G41229 CA Primary

Addresses

Primary practice location

2067 W Vista Way Ste 280
Vista, CA 92083-6034

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 579-3203

Other identifiers 1

IdentifierTypeStateIssuer
00G412290MedicaidCA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250227001422 CA Practitioner - Pediatric Medicine 6204356777 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G41229CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centers for Family Medicine GP Pediatrics CurrentSince Dec 22, 2024 Accepting new patients
Scripps Health Current Accepting new patients
Cassidy Medical Group Inc. Current Accepting new patients
Beaver Medical Group P C Pediatrics Current Accepting new patients
Scripps Health Past Accepting new patients
Rady Children'S Hospital San Diego Past Accepting new patients
Tri-City Hospital Past Accepting new patients

Locations

4910 Airport Plaza Dr
Ste 210
Long Beach, CA 90815
Phone (562) 421-3727

3460 Katella Ave
Los Alamitos, CA 90720
Phone (310) 594-6599

26991 Crown Valley Pkwy
Mission Viejo, CA 92691
Phone (949) 393-5426

2540 N Santiago Blvd
Orange, CA 92867
Phone (714) 921-1030

145 Thunder Dr
Vista, CA 92083
Phone (760) 630-5487

2067 W Vista Way
Ste 280
Vista, CA 92083
Phone (760) 941-1440

Interoperability endpoints

  • Direct secure messaging: mkrak34549@scrippshlth.medalliesdirect.net
  • Direct secure messaging: mkrak21904@epiclp.direct-ci.com

Organizations & group practices 7

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763683200000",
    "number": "1003989419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-579-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2067 W VISTA WAY STE 280",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920836034",
            "telephone_number": "760-941-3630",
            "fax_number": "760-941-1214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAK",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G41229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G412290",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

Verify at the official NPI Registry.