Active NPI
Douglas A Krause, M.D.
- Geriatric Medicine (Family Medicine) Physician
- Port Huron, MI
National Provider Identifier
1275519183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Family Medicine) Physician
- License
- 4301035998
- Practice address
- 1979 Holland Ave
Suite C
Port Huron, MI 48060-8639 - Phone
- (810) 982-1200
- Fax
- (810) 982-6990
- NPI assigned
- Dec 22, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | 4301035998 | MI | Primary |
Addresses
Primary practice location
1979 Holland Ave
Suite C
Port Huron, MI 48060-8639
Mailing address
1979 Holland Ave
Suite C
Port Huron, MI 48060-8639
Phone (810) 982-1200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4691650 | Medicaid | MI |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Port Huron Mercy Family Care Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Certified Registered Nurse Anesthetist
- Port Huron, MI
- NPI 1740686450
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354492800000",
"number": "1275519183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1979 HOLLAND AVE",
"address_2": "SUITE C",
"city": "PORT HURON",
"state": "MI",
"postal_code": "480608639",
"telephone_number": "810-982-1200",
"fax_number": "810-982-6990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1979 HOLLAND AVE",
"address_2": "SUITE C",
"city": "PORT HURON",
"state": "MI",
"postal_code": "480608639",
"telephone_number": "810-982-1200",
"fax_number": "810-982-6990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRAUSE",
"first_name": "DOUGLAS",
"middle_name": "A",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-22",
"last_updated": "2012-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "207QG0300X",
"taxonomy_group": "",
"desc": "Family Medicine, Geriatric Medicine",
"state": "MI",
"license": "4301035998",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4691650",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Port Huron, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.