Mark S Kroll, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA32880 Issued in NJ

Practice address

501 Iron Bridge Rd
Suite 15
Freehold, NJ 07728-5304

Phone

(732) 780-0100

Fax

(732) 780-8452

NPI assigned

Feb 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205798400000",
    "number": "1174598619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 IRON BRIDGE RD",
            "address_2": "SUITE 15",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077285304",
            "telephone_number": "732-780-0100",
            "fax_number": "732-780-8452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 IRON BRIDGE RD",
            "address_2": "SUITE 15",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077285304",
            "telephone_number": "732-780-0100",
            "fax_number": "732-780-8452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROLL",
        "first_name": "MARK",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-20",
        "last_updated": "2008-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA32880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "222981046",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "33340",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408302",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaclyn Elyse Kowalczyk, PHARM D., RPH
• Robert Kowalski, PT
• Jarrah Kratzer, LCSW
• Helen Kraus, LSW
• Ashley Taylor Kravitz
• Anita D Kuderna, APN
• Ramanasri V Kudipudi, MD
• Edward M Kulback, O.D.
• Arun S. Kumar, M.D.
• Nirmal A. Kumar, M.D.

• Specialist in Freehold, NJ
• Providers in Freehold, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; 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.