Individual provider Active NPI

Stephen M Krant, M.D.

  • Plastic Surgery Physician
  • La Jolla, CA
National Provider Identifier
1467571448
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
G29780 Issued in CA
Practice address
528 Nautilus St
La Jolla, CA 92037-6138
Phone
(858) 454-3161
Fax
(858) 459-2442
NPI assigned
Mar 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X G29780 CA Primary

Addresses

Primary practice location

528 Nautilus St
La Jolla, CA 92037-6138

Mailing address

528 Nautilus St
La Jolla, CA 92037-6138
Phone (858) 454-3161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20040108001228 CA Practitioner - Plastic and Reconstructive Surgery 4183524036 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Yale University School of Medicine, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

528 Nautilus St
La Jolla, CA 92037-6138
Phone (858) 454-3161

Hospital & facility affiliations

  • Scripps Memorial Hospital la Jolla Hospital, La Jolla, CA, CCN 050324

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision25
Removal of tissue158
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G29780CAMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Stephen M. Krant M.D. a Medical Corporation CurrentSince Jan 29, 2011 Accepting new patients
SK Cllinic Surgical Center PastSince Jan 29, 2011 Accepting new patients

Locations

528 Nautilus St
La Jolla, CA 92037
Phone (858) 454-3161

Interoperability endpoints

  • Direct secure messaging: skrant28483@scrippshlth.medalliesdirect.net

Organizations & group practices 3

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 1

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": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467571448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 NAUTILUS ST",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920376138",
            "telephone_number": "858-454-3161",
            "fax_number": "858-459-2442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "528 NAUTILUS ST",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920376138",
            "telephone_number": "858-454-3161",
            "fax_number": "858-459-2442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRANT",
        "first_name": "STEPHEN",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "G29780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.