Individual provider Active NPI

George Thomas Krucik, M.D.

  • Family Medicine Physician
  • San Francisco, CA
National Provider Identifier
1235132044
Registry record updated Nov 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
AFE30445 Issued in CA
Practice address
48 Loraine CT
San Francisco, CA 94118-4216
Phone
(415) 668-0896
Fax
(415) 668-0896
NPI assigned
May 24, 2005
Last updated
Nov 2, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X AFE30445 CA Primary

Addresses

Primary practice location

48 Loraine CT
San Francisco, CA 94118-4216

Mailing address

48 Loraine CT
San Francisco, CA 94118-4216
Phone (415) 668-0896

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
AFE30445CAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320192000000",
    "number": "1235132044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 LORAINE CT",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941184216",
            "telephone_number": "415-668-0896",
            "fax_number": "415-668-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 LORAINE CT",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941184216",
            "telephone_number": "415-668-0896",
            "fax_number": "415-668-0896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUCIK",
        "first_name": "GEORGE",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2011-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "AFE30445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; 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.