Individual provider Active NPI

Robert Alan Krasnick, MD

  • Physical Medicine & Rehabilitation Physician
  • Ann Arbor, MI
National Provider Identifier
1497765077
Registry record updated Apr 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
4301067247 Issued in MI
Practice address
210 Little Lake Dr Ste 8
Ann Arbor, MI 48103-6218
Phone
(734) 585-5653
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 4301067247 MI Primary

Addresses

Primary practice location

210 Little Lake Dr Ste 8
Ann Arbor, MI 48103-6218

Mailing address

210 Little Lake Dr Ste 8
Ann Arbor, MI 48103-6218
Phone (734) 585-5653

Other identifiers 1

IdentifierTypeStateIssuer
3257939MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20231130003681 MI Order and Referring Only - Physical Medicine and RehabilitationPractitioner - Physical Medicine and Rehabilitation 4385535632

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Pain Management
Education
University of Michigan Medical School, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Therapy Centers, IncGroup PAC ID 5092605717, 140 clinicians

Practice addresses (Care Compare)

33010 Northwestern Hwy
West Bloomfield, MI 48322-3634

Hospital & facility affiliations

  • Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Macomb Neurology Associates PC Past Accepting new patients

Organizations & group practices 2

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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587686400000",
    "number": "1497765077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 LITTLE LAKE DR STE 8",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481036218",
            "telephone_number": "734-585-5653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 LITTLE LAKE DR STE 8",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481036218",
            "telephone_number": "734-585-5653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRASNICK",
        "first_name": "ROBERT",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2020-04-24",
        "certification_date": "2020-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "4301067247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3257939",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.