NPIMap

Individual provider Active NPI

Kevin R Krause, MD

  • Surgery Physician
  • Berkley, MI
National Provider Identifier
1194813253
Registry record updated Sep 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
4301063555 Issued in MI
Practice address
1695 12 Mile Rd
Suite 220
Berkley, MI 48072
Phone
(248) 551-8180
Fax
(248) 551-8181
NPI assigned
Oct 11, 2006
Last updated
Sep 26, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 4301063555 MI Primary

Addresses

Primary practice location

1695 12 Mile Rd
Suite 220
Berkley, MI 48072

Mailing address

1695 12 Mile Rd
Suite 220
Berkley, MI 48072-2100
Phone (248) 551-8180

Other identifiers 1

IdentifierTypeStateIssuer
4347880MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kkrause27136@direct.beaumont.edu

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101027000406 MI Practitioner - General Surgery 6800080540 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Wayne State University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Royal Oak Surgical Associates PCGroup PAC ID 6406849850, 4 clinicians

Practice addresses (Care Compare)

3535 W 13 Mile Rd
Royal Oak, MI 48073-6770
Phone (248) 551-8180

44201 Dequindre Rd
Troy, MI 48085-1198
Phone (248) 964-5000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)11
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301063555MIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Royal Oak Surgical Associates PC Surgery CurrentSince Jul 15, 2001 Accepting new patients
Osu Surgery, LLC Surgery Past Accepting new patients
William Beaumont Hospital Past Accepting new patients

Locations

1695 12 Mile Rd
Ste 220
Berkley, MI 48072
Phone (248) 545-6100

3535 W 13 Mile Rd
Ste 205
Royal Oak, MI 48073
Phone (248) 288-2188

3601 W 13 Mile Rd
Royal Oak, MI 48073

Interoperability endpoints

  • Direct secure messaging: kkrause27136@direct.beaumont.edu

Organizations & group practices 3

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758844800000",
    "number": "1194813253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1695 12 MILE RD",
            "address_2": "SUITE 220",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480722100",
            "telephone_number": "248-551-8180",
            "fax_number": "248-551-8181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1695 12 MILE RD",
            "address_2": "SUITE 220",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "48072",
            "telephone_number": "248-551-8180",
            "fax_number": "248-551-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAUSE",
        "first_name": "KEVIN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301063555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4347880",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkrause27136@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "3535 W 13 Mile Rd",
            "address_2": "Ste 205",
            "city": "Royal Oak",
            "state": "MI",
            "country_code": "US",
            "postal_code": "48073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Berkley, MI

Sources for this page

Verify at the official NPI Registry.