Individual provider Active NPI

Frank Daniel Kresock Jr., MD

  • Cardiovascular Disease Physician
  • Parker, AZ
National Provider Identifier
1316948169
Registry record updated Jul 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
26534 Issued in AZ
Practice address
1413 W 16TH St
The Cardiovascular Center
Parker, AZ 85344-6310
Phone
(928) 669-8161
Fax
(928) 669-8171
NPI assigned
Aug 2, 2005
Last updated
Jul 8, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 26534 AZ Primary

Addresses

Primary practice location

1413 W 16TH St
The Cardiovascular Center
Parker, AZ 85344-6310

Mailing address

1413 W 16TH St
The Cardiovascular Center
Parker, AZ 85344-6310
Phone (928) 669-8161

Other identifiers 3

IdentifierTypeStateIssuer
110161929OtherAZRAILROAD MEDICARE
429698MedicaidAZ
WCSKQOtherAZSUN HEALTH GRP #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20040816000255 AZ Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Peripheral Vascular DiseasePractitioner - Critical Care (Intensivists)Practitioner - Cardiac ElectrophysiologyPractitioner - Family PracticePractitioner - General PracticePractitioner - Internal Medicine 1850364118

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Cardiology Group, PC Past Accepting new patients
Hosea E Brown MD Inc Past Accepting new patients
Advanced Cardiac Specialists, Chartered Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247011200000",
    "number": "1316948169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1413 W 16TH ST",
            "address_2": "THE CARDIOVASCULAR CENTER",
            "city": "PARKER",
            "state": "AZ",
            "postal_code": "853446310",
            "telephone_number": "928-669-8161",
            "fax_number": "928-669-8171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1413 W 16TH ST",
            "address_2": "THE CARDIOVASCULAR CENTER",
            "city": "PARKER",
            "state": "AZ",
            "postal_code": "853446310",
            "telephone_number": "928-669-8161",
            "fax_number": "928-669-8171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRESOCK",
        "first_name": "FRANK",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2009-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AZ",
            "license": "26534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110161929",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "429698",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUN HEALTH GRP #",
            "identifier": "WCSKQ",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parker, AZ

Sources for this page

Verify at the official NPI Registry.