Stephen Kroczek, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

01020134A Issued in IN

Practice address

1225 E Coolspring Ave
Michigan City, IN 46360-6312

Phone

(219) 878-5034

Fax

(219) 878-5002

NPI assigned

Jan 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Medical Group Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Michigan City, IN
  • NPI 1760518617
  NPD (past)

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312761600000",
    "number": "1013987767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 E COOLSPRING AVE",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463606312",
            "telephone_number": "219-878-5034",
            "fax_number": "219-878-5002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 E COOLSPRING AVE",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463606312",
            "telephone_number": "219-878-5034",
            "fax_number": "219-878-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROCZEK",
        "first_name": "STEPHEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2011-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IN",
            "license": "01020134A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100261620",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vidya Kora, MD
• Robert Korsch, D.O.
• Bridgette Renee Koselke
• Michael Kosteskie, OT
• Rebecca Louise Kray, FNP-BC
• Abbi Danae Kroll, NP
• Michelle Lynn Krsteski, PHARMD, MS
• Cheryl Krueger, FNP
• Mandavi Kulkarni, MD
• Jaroslaw Kuna, M.D.

• Ophthalmology Physician in Michigan City, IN
• Providers in Michigan City, IN by specialty
• Ophthalmology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.