Individual provider Active NPI

Michael J Kricko, DO

  • Internal Medicine Physician
  • Newport, NH
National Provider Identifier
1215029905
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
22549 Issued in NH
Practice address
11 John Stark Hwy
Newport, NH 03773-1807
Phone
(603) 863-4100
Fax
(603) 863-8074
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS13691 FL
Internal Medicine Physician 207R00000X 22549 NH Primary

Addresses

Primary practice location

11 John Stark Hwy
Newport, NH 03773-1807

Mailing address

273 County Rd
New London, NH 03257-7700
Phone (603) 526-5259

Other practice location 1

273 County Rd
New London, NH 03257-7700
Phone (603) 526-2911

Other practice location 2

273 County Rd
New London, NH 03257-7700
Phone (603) 526-2911

Other practice location 3

2004 N Flamingo Rd
Pembroke Pines, FL 33028-3500
Phone (954) 450-8500

Other practice location 4

4780 SW 64th Ave Ste 101
Davie, FL 33314-4400
Phone (954) 434-1705

Other practice location 5

1604 Town Center Blvd Ste 4B
Weston, FL 33326-3640
Phone (954) 384-1800

Other practice location 6

4801 S University Dr Ste 110
Davie, FL 33328-3835
Phone (954) 434-1705

Other practice location 7

2122 NW 62nd Street
Suite 110
Fort Lauderdale, Florida 33309
Phone (954) 353-3180

Other identifiers 1

IdentifierTypeStateIssuer
3133928MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20220516002209 NH Practitioner - Internal Medicine 5496741647 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Michigan Homeopathic Medical School, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The New London Hospital Association IncGroup PAC ID 5294643623, 66 clinicians

Practice addresses (Care Compare)

11 John Stark Hwy
Newport, NH 03773-1807
Phone (603) 526-5215

273 Country Rd
New London, NH 03257-5736
Phone (603) 526-5215

Hospital & facility affiliations

  • Lake Sunapee Home Care & Hospice Home health agency, New London, NH, CCN 307040
  • New London Hospital Hospital, New London, NH, CCN 301304
  • Valley Regional Hospital Hospital, Claremont, NH, CCN 301308
  • Mary Hitchcock Memorial Hospital Hospital, Lebanon, NH, CCN 300003

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22549NHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The New London Hospital Association, Inc. CurrentSince Apr 6, 2022 Accepting new patients
Associatesmd Medical Group Inc CurrentSince Sep 1, 2020 Accepting new patients
The New London Hospital Association, Inc. CurrentSince Apr 6, 2022 Accepting new patients
The New London Hospital Association, Inc. Internal Medicine CurrentSince Oct 1, 2025 Accepting new patients

Locations

4780 SW 64th Ave
Ste 101
Davie, FL 33314

4780 SW 64th Ave
Ste 103
Davie, FL 33314

4801 S University Dr
Ste 110
Davie, FL 33328
Phone (954) 434-8588

2122 W Cypress Creek Rd
Ste 110
Ft Lauderdale, FL 33309
Phone (954) 353-3180

2004 N Flamingo Rd
Pembroke Pnes, FL 33028
Phone (954) 450-8500

1604 Town Center Blvd
Ste 4B
Weston, FL 33326
Phone (954) 384-1800

273 County Rd
New London, NH 03257
Phone (603) 526-5215

11 John Stark Hwy
Newport, NH 03773
Phone (603) 526-5203

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JIDJCA
  • Direct secure messaging: mkricko463384@direct.dartmouth-hitchcock.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1215029905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "273 COUNTY RD",
            "city": "NEW LONDON",
            "state": "NH",
            "postal_code": "032577700",
            "telephone_number": "603-526-5259",
            "fax_number": "603-526-5290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 JOHN STARK HWY",
            "city": "NEWPORT",
            "state": "NH",
            "postal_code": "037731807",
            "telephone_number": "603-863-4100",
            "fax_number": "603-863-8074"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "273 County Rd",
            "address_purpose": "LOCATION",
            "city": "New London",
            "state": "NH",
            "postal_code": "032577700",
            "country_code": "US",
            "telephone_number": "603-526-2911",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "273 County Rd",
            "address_purpose": "LOCATION",
            "city": "New London",
            "state": "NH",
            "postal_code": "032577700",
            "country_code": "US",
            "telephone_number": "603-526-2911",
            "fax_number": "603-526-5290",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2004 N Flamingo Rd",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330283500",
            "country_code": "US",
            "telephone_number": "954-450-8500",
            "fax_number": "954-450-8502",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4780 SW 64th Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Davie",
            "state": "FL",
            "postal_code": "333144400",
            "country_code": "US",
            "telephone_number": "954-434-1705",
            "fax_number": "954-434-1882",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1604 Town Center Blvd Ste 4B",
            "address_purpose": "LOCATION",
            "city": "Weston",
            "state": "FL",
            "postal_code": "333263640",
            "country_code": "US",
            "telephone_number": "954-384-1800",
            "fax_number": "954-384-1802",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4801 S University Dr Ste 110",
            "address_purpose": "LOCATION",
            "city": "Davie",
            "state": "FL",
            "postal_code": "333283835",
            "country_code": "US",
            "telephone_number": "954-434-1705",
            "fax_number": "855-545-1342",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2122 NW 62nd Street",
            "address_2": "Suite 110",
            "address_purpose": "LOCATION",
            "city": "Fort Lauderdale",
            "state": "Florida",
            "postal_code": "33309",
            "country_code": "US",
            "telephone_number": "954-353-3180",
            "fax_number": "954-353-3185",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRICKO",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2022-10-28",
        "certification_date": "2022-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS13691",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NH",
            "license": "22549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3133928",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, NH

Sources for this page

Verify at the official NPI Registry.