Active NPI
Jeffrey Alan Kraut, MD
- Internal Medicine Physician
- Los Angeles, CA
National Provider Identifier
1124040043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- G36377
- Practice address
- 200 Medical Plaza
#365,530,420,120
Los Angeles, CA 90095 - Phone
- (310) 794-9718
- NPI assigned
- Jul 24, 2006
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | G36377 | CA | Primary |
Addresses
Primary practice location
200 Medical Plaza
#365,530,420,120
Los Angeles, CA 90095
Mailing address
File #55737
Los Angeles, CA 90074
Phone (310) 301-8708
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G363770 | Other | CA | MEDICAL PPIN # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G36377 | CA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124040043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "FILE #55737",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90074",
"telephone_number": "310-301-8708",
"fax_number": "310-301-8751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 MEDICAL PLAZA",
"address_2": "#365,530,420,120",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90095",
"telephone_number": "310-794-9718"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRAUT",
"first_name": "JEFFREY",
"middle_name": "ALAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "G36377",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL PPIN #",
"identifier": "00G363770",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.