Matthew David Krasucki, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

54586-20 Issued in WI

Practice address

1720 W Florist Ave Unit 203
Glendale, WI 53209-3800

Phone

(414) 649-7909

NPI assigned

Apr 25, 2008

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 WI

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

Specialty

Psychiatry

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Waukesha CountyGroup PAC ID 3971405481, 29 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Waukesha County

  • Case Management Agency
  • Waukesha, WI
  • NPI 1740403146
  Medicare reassignment Care Compare group NPD
• Washington County Wisconsin

  • Community/Behavioral Health Agency
  • West Bend, WI
  • NPI 1609801778
  Medicare reassignment NPD
• Waukesha County

  • Psychiatric Hospital
  • Waukesha, WI
  • NPI 1407988892
  NPD
• Waukesha County

  • Mental Illness Community Based Residential Treatment Facility
  • Waukesha, WI
  • NPI 1477314854
  NPD
• Aurora Health Care Metro, Inc.

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1861447179
  NPD (past)
• Waukesha County

  • Case Management Agency
  • Waukesha, WI
  • NPI 1003930223
  NPD (past)
• Waukesha County

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waukesha, WI
  • NPI 1033243340
  NPD (past)
• Waukesha County

  • Primary Care Clinic/Center
  • Waukesha, WI
  • NPI 1346364585
  NPD (past)
• Waukesha County

  • Case Management Agency
  • Waukesha, WI
  • NPI 1831316371
  NPD (past)

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

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1497920995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N54W26176 BODEN LN",
            "city": "SUSSEX",
            "state": "WI",
            "postal_code": "530894269",
            "telephone_number": "630-995-1130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 W FLORIST AVE UNIT 203",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532093800",
            "telephone_number": "414-649-7909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRASUCKI",
        "first_name": "MATTHEW",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-25",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WI",
            "license": "54586-020",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "54586-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stanislav Kononov, LMT
• Rishi Kora, M.D.
• Melinda M Korish, PROFESSIONAL COUNSEL
• Emily Rose Kowal, MD
• Jeffery David Kowitz, DVM
• Olivia Krause, PT
• Kathryn Krebsbach, RDN,CD
• John T Kroner, MD
• Joseph Kroner
• Courtney Kruggel, PT

• Psychiatry Physician in Glendale, WI
• Providers in Glendale, WI by specialty
• Psychiatry Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; 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.