Mark A. R. Kryskow, DO

Primary specialty

Surgical Critical Care PhysicianTaxonomy code 2086S0102X

License

11634089-1204 Issued in UT

Practice address

30 N 1900 E RM 3C344
Salt Lake City, UT 84132-0002

Phone

(801) 585-1618

NPI assigned

Jun 9, 2015

Last updated

Jun 11, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT, MA2 enrollments

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 2

Specialty

General Surgery

Education

University of New England, College of Osteo Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Berkshire Faculty Services IncGroup PAC ID 8224068424, 276 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Berkshire Visiting Nurse Association Home health agency, Pittsfield, MA, CCN 227122
• Berkshire Medical Center Hospital, Pittsfield, MA, CCN 220046
• North Adams Regional Hospital Corporation Hospital, North Adams, MA, CCN 221304
• Fairview Hospital Hospital, Great Barrington, MA, CCN 221302

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Berkshire Faculty Services Inc

  • Multi-Specialty Clinic/Center
  • Pittsfield, MA
  • NPI 1548212939
  Medicare reassignment Care Compare group NPD
• University of Utah Acuity Care Services

  dba Anesthesiology Dept SICU

  • Critical Care Medicine (Anesthesiology) Physician
  • Salt Lake City, UT
  • NPI 1407250541
  Medicare reassignment NPD
• University of Utah Adult Services

  • General Practice Physician
  • Salt Lake City, UT
  • NPI 1114321981
  Medicare reassignment NPD
• University of Utah Acuity Care Services

  dba Neurostimulation Adult Services

  • Neuromuscular Medicine (Psychiatry & Neurology) Physician
  • Salt Lake City, UT
  • NPI 1366804254
  NPD
• University of Utah Acuity Care Services

  dba MICU-Department of University of Utah

  • Critical Care Medicine (Internal Medicine) Physician
  • Salt Lake City, UT
  • NPI 1851795918
  NPD
• University of Utah Adult Services

  dba University of Utah Hospital Radiology Department

  • Diagnostic Radiology Physician
  • Salt Lake City, UT
  • NPI 1598169419
  NPD
• University of Utah Adult Services

  dba University Hospital Internal Medicine Cardiology EP Dept.

  • Clinical Cardiac Electrophysiology Physician
  • Salt Lake City, UT
  • NPI 1851795652
  NPD
• Fairview Hospital

  dba East Mountain Medical

  • Rural Health Clinic/Center
  • Great Barrington, MA
  • NPI 1881252286
  NPD
• Berkshire Medical Center, Inc

  • General Acute Care Hospital
  • Pittsfield, MA
  • NPI 1295765261
  NPD (past)

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

• Berkshire Medical Center, Inc

  • General Acute Care Hospital
  • Pittsfield, MA
  • NPI 1295765261
  Care Compare affiliation
• Berkshire Medical Center, Inc.

  • Home Health Agency
  • Pittsfield, MA
  • NPI 1205948973
  Care Compare affiliation
• Fairview Hospital

  • Critical Access Hospital
  • Great Barrington, MA
  • NPI 1730112251
  Care Compare affiliation
• North Adams Regional Hospital Corporation

  • Critical Access Hospital
  • North Adams, MA
  • NPI 1437839669
  Care Compare affiliation

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

{
    "created_epoch": "1433808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591833600000",
    "number": "1407237092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N 1900 E RM 3C344",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320002",
            "telephone_number": "801-585-1618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N 1900 E RM 3C344",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320002",
            "telephone_number": "801-585-1618"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 North St",
            "address_2": "Dept of surgery",
            "address_purpose": "LOCATION",
            "city": "Pittsfield",
            "state": "MA",
            "postal_code": "012014109",
            "country_code": "US",
            "telephone_number": "303-819-7645",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRYSKOW",
        "first_name": "MARK",
        "middle_name": "A. R.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-09",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "262547",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "UT",
            "license": "11634089-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kacy Lynn Krummel
• Sarah Krupa
• Denis Krutko, MD
• Moira Flannery Kryger, RD, IBCLC, CD
• Nicole Jane Kryger
• Katelyn Kubiak
• Georgia Blackwood Kubic, M.D.
• Katherine Juniata Kubicka-Perez, MD
• Kimberly K. Kucharski, MD
• Christine Kuchma

• Surgical Critical Care Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Surgical Critical Care Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.