Individual provider Active NPI

Jessica Krausz

  • Dentist
  • Smithtown, NY
National Provider Identifier
1114254992
Registry record updated Mar 10, 2013
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Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
054970 Issued in NY
Practice address
269 E Main St
Suite E
Smithtown, NY 11787-2832
Phone
(631) 724-0327
NPI assigned
Nov 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 054970 NY Primary

Addresses

Primary practice location

269 E Main St
Suite E
Smithtown, NY 11787-2832

Mailing address

139 Paddington Cir
Smithtown, NY 11787-5905

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150227001483 NY Order and Referring Only - DentistPractitioner - Dentist 2860718392

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
054970NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1258329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362873600000",
    "number": "1114254992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 PADDINGTON CIR",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117875905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 E MAIN ST",
            "address_2": "SUITE E",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872832",
            "telephone_number": "631-724-0327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAUSZ",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-16",
        "last_updated": "2013-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "054970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.