NPIMap

Individual provider Active NPI

Jesse C. Krakauer, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Berkley, MI
National Provider Identifier
1073582417
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
4301043287 Issued in MI
Practice address
2905 12 Mile Rd
Berkley, MI 48072-1413
Phone
(248) 541-0770
Fax
(248) 415-1672
NPI assigned
Mar 17, 2006
Last updated
Jan 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 4301043287 MI Primary

Addresses

Primary practice location

2905 12 Mile Rd
Berkley, MI 48072-1413

Mailing address

2805 Pontiac Lake Rd Ste 2B
Waterford, MI 48328-2680
Phone (248) 541-0770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050104000918 MI Practitioner - EndocrinologyPractitioner - Internal Medicine 2961450150 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Stanford University School of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pikal PLCGroup PAC ID 1254508005, 4 clinicians

Practice addresses (Care Compare)

2905 W 12 Mile Rd
Berkley, MI 48072-1413
Phone (248) 541-0770

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone (248) 551-5000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pikal PLC CurrentSince Oct 1, 2024 Accepting new patients
Associated Physicians Group PLC CurrentSince Jan 1, 2020 Accepting new patients
Osteoporosis Testing Centers Inc Past Accepting new patients

Locations

1695 12 Mile Rd
Ste 200
Berkley, MI 48072
Phone (248) 545-8690

2905 W 12 Mile Rd
Berkley, MI 48072
Phone (248) 541-0770

3601 W 13 Mile Rd
Royal Oak, MI 48073

Organizations & group practices 4

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1073582417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2805 PONTIAC LAKE RD STE 2B",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483282680",
            "telephone_number": "248-541-0770",
            "fax_number": "248-415-1672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 12 MILE RD",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480721413",
            "telephone_number": "248-541-0770",
            "fax_number": "248-415-1672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAKAUER",
        "first_name": "JESSE",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MI",
            "license": "4301043287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkley, MI

Sources for this page

Verify at the official NPI Registry.