Active NPI
Matthew Keith Kraciun, DO
- Family Medicine Physician
- Dubuque, IA
National Provider Identifier
1104356997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 05247
- Practice address
- 1500 Associates Dr
Dubuque, IA 52002-2201 - Phone
- (563) 584-4450
- Fax
- (563) 584-4295
- NPI assigned
- Jun 14, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 05247 | IA | Primary |
Addresses
Primary practice location
1500 Associates Dr
Dubuque, IA 52002-2201
Mailing address
1500 Associates Dr
Dubuque, IA 52002-2201
Phone (563) 584-4450
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200709001696 | IA | Practitioner - Family Practice | 8628340262 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Kansas City University of Physicians and Surgeons, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Medical Associates Clinic P CUnified Therapy Services, Inc
Practice addresses (Care Compare)
1500 Associates Dr
Dubuque, IA 52002-2201
Phone (563) 584-4100
4135 Pennsylvania Ave
Dubuque, IA 52002-2628
Hospital & facility affiliations
- 24 Hour Care, LLC
- In-Home Care Connection Home Health Services
- Hospice of Dubuque
- Mercyone Dubuque Medical Center
- Finley Hospital
- Mercyone Dyersville Medical Center
- Stonehill Care Center
- Hawkeye Care Center Dubuque
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 11 |
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05247 | IA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Associates Clinic P C | Current | Accepting new patients |
Locations
1500 Associates Dr
Dubuque, IA 52002
Phone (563) 584-4100
1000 Langworthy St
Dubuque, IA 52001
Phone (563) 584-3455
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 and National Provider Directory roles.
-
- Durable Medical Equipment & Medical Supplies
- Dubuque, IA
- NPI 1811091143
-
- Physical Therapist
- Dubuque, IA
- NPI 1619064086
-
- Occupational Therapist
- Fennimore, WI
- NPI 1639727035
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Galena, IL
- NPI 1891084596
-
- Home Health Agency
- Moline, IL
- NPI 1184150419
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593475200000",
"number": "1104356997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 ASSOCIATES DR",
"city": "DUBUQUE",
"state": "IA",
"postal_code": "520022201",
"telephone_number": "563-584-4450",
"fax_number": "563-584-4295"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 ASSOCIATES DR",
"city": "DUBUQUE",
"state": "IA",
"postal_code": "520022201",
"telephone_number": "563-584-4450",
"fax_number": "563-584-4295"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRACIUN",
"first_name": "MATTHEW",
"middle_name": "KEITH",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-14",
"last_updated": "2020-06-30",
"certification_date": "2020-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "05247",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dubuque, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; 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.