Susanne M Krasovich, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

47105 Issued in WI

Practice address

210 NW Barstow St
Waukesha Family Practice Center
Waukesha, WI 53188-3771

Phone

(262) 548-6903

Fax

(262) 548-3820

NPI assigned

May 15, 2006

Last updated

Oct 8, 2013By the provider in NPPES

Sex

Female

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 2

Medicare fee-for-service enrollment

Enrolled in WI

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

Family Practice

Education

Geisel School of Medicine at Dartmouth, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Waukesha Memorial Hospital Hospital, Waukesha, WI, CCN 520008

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/4389/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71885
• Direct secure messaging: skrasovich10124@direct.phci.org

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.

• Prohealth Medical Group Inc.

  • Pediatrics Physician
  • Waukesha, WI
  • NPI 1356322440

  Family Medicine

  Medicare reassignment Care Compare group NPD
• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086

  Family Medicine

  Medicare reassignment NPD
• Prohealth Medical Group Inc

  • Family Medicine Physician
  • Pewaukee, WI
  • NPI 1396887709
  NPD
• Prohealth Waukesha Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Waukesha, WI
  • NPI 1629056890
  NPD (past)
• Anita S. Westafer, M.D., P.a.

  • Family Medicine Physician
  • Gulf Breeze, FL
  • NPI 1972565091
  NPD (past)
• Whidbey Medical Clinic PLLC

  • Clinic/Center
  • Oak Harbor, WA
  • NPI 1548260177

  Family Medicine

  NPD (past)

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

• Prohealth Waukesha Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Waukesha, WI
  • NPI 1629056890
  Care Compare affiliation

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381190400000",
    "number": "1043261886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 NW BARSTOW ST",
            "address_2": "WAUKESHA FAMILY PRACTICE CENTER",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531883771",
            "telephone_number": "262-548-6903",
            "fax_number": "262-548-3820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 NW BARSTOW ST",
            "address_2": "WAUKESHA FAMILY PRACTICE CENTER",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531883771",
            "telephone_number": "262-548-6903",
            "fax_number": "262-548-3820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRASOVICH",
        "first_name": "SUSANNE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-15",
        "last_updated": "2013-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "47105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "029906261Q",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043261886",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna Katherine Kraft
• Barbara Joan Kraft, RN
• Travis Krahn, M.S., SAC-IT
• Donna G. Kraklow, D.D.S.
• Sarah Renee Kramer
• Susan Vaughan Kratz, OTR, CST
• Mary Kraus
• Elijah James Krause
• Edward Lloyd Kreimier III III, M.D.
• Timothy Scott Krell

• Family Medicine Physician in Waukesha, WI
• Providers in Waukesha, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2013; 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.