Individual provider Active NPI

Richard M. Kratzenberg, P.A.

  • Physician Assistant
  • Aurora, CO
National Provider Identifier
1568603645
Registry record updated Apr 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
013208 Issued in NY
Practice address
13701 E Mississippi Ave
Suite 320
Aurora, CO 80012-6141
Phone
(303) 340-3378
Fax
(303) 340-3409
NPI assigned
Mar 18, 2009
Last updated
Apr 28, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 013208 NY Primary

Addresses

Primary practice location

13701 E Mississippi Ave
Suite 320
Aurora, CO 80012-6141

Mailing address

13701 E. Mississippi Avenue
Suite 320
Aurora, CO 80012
Phone (303) 340-3378

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
013208NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Leslie R Capin MD PC PastSince Sep 1, 2013 Accepting new patients
Advanced Dermatology of Colorado, 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1237334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303948800000",
    "number": "1568603645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13701 E. MISSISSIPPI AVENUE",
            "address_2": "SUITE 320",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "80012",
            "telephone_number": "303-340-3378",
            "fax_number": "303-340-3409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13701 E MISSISSIPPI AVE",
            "address_2": "SUITE 320",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800126141",
            "telephone_number": "303-340-3378",
            "fax_number": "303-340-3409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRATZENBERG",
        "first_name": "RICHARD",
        "middle_name": "M.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-18",
        "last_updated": "2011-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "013208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.