Elsa Kracke

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

M-14165 Issued in ID

Practice address

2601 E. Roosevelt St.
Maricopa Integrated Health System
Phoenix, AZ 85008

Phone

(602) 344-1015

NPI assigned

Apr 8, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ekracke104102@direct.slhs.org

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.

• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1326336058

  Pediatrics

  Medicare reassignment NPD
• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  NPD (past)

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

{
    "created_epoch": "1428451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526860800000",
    "number": "1053707935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 E. ROOSEVELT ST.",
            "address_2": "MARICOPA INTEGRATED HEALTH SYSTEM",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 E. ROOSEVELT ST.",
            "address_2": "MARICOPA INTEGRATED HEALTH SYSTEM",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85008",
            "telephone_number": "602-344-1015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRACKE",
        "first_name": "ELSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-08",
        "last_updated": "2018-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ID",
            "license": "M-14165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Lillian Kozimor, M.ED.
• Cassidy Leigh Koziol, OTR
• Thomas Francis Kozlek, MD
• KP Chiropractic PC (Desert Valley Chiropractic)
• Bailey Elizabeth Kracht, MT-BC
• Brittney Dawn Kraeer, M.S.
• Christopher Adam Kraemer, LISAC
• Matthew Todd Kraemer, P.T.
• Terrylee Kraemer, OTR
• Adrienne Dianne Kraft, MA, LCSW, LISAC

• Pediatrics Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Pediatrics Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.

Verify at the official NPI Registry.