Individual provider Active NPI

Jeremy Vincent Krause, LMSW

  • Social Worker
  • Buffalo, NY
National Provider Identifier
1083939920
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
086083 Issued in NY
Practice address
30 Alpine PL Apt 214
Buffalo, NY 14225-3979
Phone
(617) 869-0527
NPI assigned
Apr 4, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X 086083 NY Primary

Addresses

Primary practice location

30 Alpine PL Apt 214
Buffalo, NY 14225-3979

Mailing address

30 Alpine PL Apt 214
Buffalo, NY 14225-3979
Phone (617) 869-0527

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
086083NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1270339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1083939920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 ALPINE PL APT 214",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142253979",
            "telephone_number": "617-869-0527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 ALPINE PL APT 214",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142253979",
            "telephone_number": "617-869-0527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAUSE",
        "first_name": "JEREMY",
        "middle_name": "VINCENT",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-04",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "NY",
            "license": "086083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; 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.