Individual provider Active NPI

Harry Scott Krulewitch, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Portland, OR
National Provider Identifier
1598799553
Registry record updated Nov 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
MD10273 Issued in OR
Practice address
1101 SW Coronado St
Portland, OR 97219-7625
Phone
(360) 260-8225
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X MD10273 OR Primary

Addresses

Primary practice location

1101 SW Coronado St
Portland, OR 97219-7625

Mailing address

1101 SW Coronado St
Portland, OR 97219-7625
Phone (360) 260-8225

Other identifiers 1

IdentifierTypeStateIssuer
287059MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20110428000637 OR Practitioner - Family PracticePractitioner - Geriatric Medicine 0143116152

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
John H. Addison MD PS Past Accepting new patients
Neal Allan Dunitz, MD Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8442/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195084800000",
    "number": "1598799553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 SW CORONADO ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972197625",
            "telephone_number": "360-260-8225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 SW CORONADO ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972197625",
            "telephone_number": "360-260-8225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRULEWITCH",
        "first_name": "HARRY",
        "middle_name": "SCOTT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "OR",
            "license": "MD10273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287059",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.