Individual provider Active NPI

Mark H. Krotowski, M.D.

  • Family Medicine Physician
  • Lawrence, NY
National Provider Identifier
1538165311
Registry record updated Aug 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
135198 Issued in NY
Practice address
525 Jorgen St
Lawrence, NY 11559
Phone
(516) 569-6781
Fax
(516) 569-6745
NPI assigned
Jun 25, 2005
Last updated
Aug 1, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 135198 NY Primary

Addresses

Primary practice location

525 Jorgen St
Lawrence, NY 11559

Mailing address

525 Jorgen St
Lawrence, NY 11559-2531
Phone (516) 569-6781

Other identifiers 1

IdentifierTypeStateIssuer
00420659MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20101005000002 NY Practitioner - Family Practice 8921290370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

470 Clarkson Ave
Brooklyn, NY 11203-2012
Phone (718) 270-1000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospital of Brooklyn Suny Downstate Health Sciences Univers Family Medicine Current Accepting new patients
University Hospital of Brooklyn Suny Downstate Health Sciences Univers CurrentSince Jan 1, 2022 Accepting new patients
University Hospital of Brooklyn Suny Downstate Health Sciences Univers CurrentSince Jan 1, 2022 Accepting new patients

Locations

470 Clarkson Ave
Brooklyn, NY 11203
Phone (718) 826-4900

840 Lefferts Ave
Brooklyn, NY 11203
Phone (718) 493-0300

Interoperability endpoints

  • Direct secure messaging: markkrotowski@sunydmc.allscriptsdirect.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1119657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533081600000",
    "number": "1538165311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 JORGEN ST",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115592531",
            "telephone_number": "516-569-6781",
            "fax_number": "516-569-6745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 JORGEN ST",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "11559",
            "telephone_number": "516-569-6781",
            "fax_number": "516-569-6745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROTOWSKI",
        "first_name": "MARK",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-25",
        "last_updated": "2018-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "135198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00420659",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, NY

Sources for this page

Verify at the official NPI Registry.