Individual provider Active NPI

Graham Krasan

  • Pediatric Infectious Diseases Physician
  • Royal Oak, MI
National Provider Identifier
1174582506
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X
License
4301075091 Issued in MI
Practice address
3535 W 13 Mile Rd
Ste. 707
Royal Oak, MI 48073-6710
Phone
(248) 551-0087
NPI assigned
Mar 23, 2006
Last updated
Oct 22, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Infectious Diseases Physician 2080P0208X 4301075091 MI Primary

Addresses

Primary practice location

3535 W 13 Mile Rd
Ste. 707
Royal Oak, MI 48073-6710

Mailing address

3601 W 13 Mile Rd
400-FSC/PCS
Royal Oak, MI 48073-6712

Other identifiers 2

IdentifierTypeStateIssuer
4735844MedicaidMI
440F361390OtherMIBCBSM

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gkrasan16231@direct.beaumont.edu

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070430000610 MI Practitioner - Infectious DiseasePractitioner - Pediatric Medicine 2365548898 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.37 of 100Reported as group
Quality
66.73
Promoting interoperability
100
Improvement activities
40
Cost
70.98

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301075091MIMDPediatric Infectious Diseases Physician

Practice roles

OrganizationSpecialtyStatusNew patients
William Beaumont Hospital Current Accepting new patients
Beaumont Medical Group- Specialty Services CurrentSince Mar 21, 2018 Accepting new patients
William Beaumont Hospital CurrentSince May 17, 2016 Accepting new patients
William Beaumont Hospital CurrentSince May 17, 2016 Accepting new patients
William Beaumont Hospital Past Accepting new patients

Locations

28100 Grand River Ave
Ste 301
Farmington Hills, MI 48336
Phone (947) 521-1320

3535 W 13 Mile Rd
Ste 707
Royal Oak, MI 48073
Phone (248) 551-0487

3601 W 13 Mile Rd
Royal Oak, MI 48073

3601 W 13 Mile Rd
#400
Royal Oak, MI 48073
Phone (248) 423-2481

26001 Jefferson Ave
Saint Clair Shores, MI 48081
Phone (586) 779-7000

130 Town Center Dr
Ste 203
Troy, MI 48084
Phone (248) 585-8250

Interoperability endpoints

  • Direct secure messaging: gkrasan16231@direct.beaumont.edu
  • Direct secure messaging: gkrasan216164@epic00.shdirect.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1174582506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE RD",
            "address_2": "400-FSC/PCS",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 W 13 MILE RD",
            "address_2": "STE. 707",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736710",
            "telephone_number": "248-551-0087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRASAN",
        "first_name": "GRAHAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "MI",
            "license": "4301075091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4735844",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "440F361390",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gkrasan16231@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "3535 W 13 Mile Rd",
            "address_2": "Ste. 707",
            "city": "Royal Oak",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480736710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.