Individual provider Active NPI

Anatole Krukas, MD

  • Addiction Medicine (Internal Medicine) Physician
  • Lake Worth, FL
National Provider Identifier
1043229941
Registry record updated Sep 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X
License
ME114799 Issued in FL
Practice address
Central Florida Substance Abuse Treatment Center
3155 Lake Worth Rd
Lake Worth, FL 33461
Phone
(561) 439-8440
NPI assigned
Aug 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Internal Medicine) Physician 207RA0401X ME114799 FL Primary

Addresses

Primary practice location

Central Florida Substance Abuse Treatment Center
3155 Lake Worth Rd
Lake Worth, FL 33461

Mailing address

Central Florida Substance Abuse Treatment Center
3155 Lake Worth Rd
Lake Worth, FL 33461
Phone (561) 439-8440

Other practice location 1

1905 W Cedar St
El Dorado, AR 71730-6835
Phone (917) 304-4840

Other identifiers 1

IdentifierTypeStateIssuer
009917500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME114799FLMDAddiction Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Medical Group, Arkansas, PA Past Accepting new patients
Hospitalist Medicine Physician of Broome County PLLC Past Accepting new patients
South Arkansas Physician Services LLC PastSince Oct 1, 2012 Accepting new patients

Organizations & group practices 3

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": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1043229941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CENTRAL FLORIDA SUBSTANCE ABUSE TREATMENT CENTER",
            "address_2": "3155 LAKE WORTH RD",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "33461",
            "telephone_number": "561-439-8440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CENTRAL FLORIDA SUBSTANCE ABUSE TREATMENT CENTER",
            "address_2": "3155 LAKE WORTH RD",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "33461",
            "telephone_number": "561-439-8440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1905 W Cedar St",
            "address_purpose": "LOCATION",
            "city": "El Dorado",
            "state": "AR",
            "postal_code": "717306835",
            "country_code": "US",
            "telephone_number": "917-304-4840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRUKAS",
        "first_name": "ANATOLE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "FL",
            "license": "ME114799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009917500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2018; 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.