Individual provider Active NPI

Andrew Kraska, PA-C

  • Medical Physician Assistant
  • Garner, NC
National Provider Identifier
1619608056
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
200 Health Park Dr Ste 100
Garner, NC 27529-4679
Phone
(919) 773-1223
NPI assigned
Jun 17, 2022
Last updated
Aug 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X NU Primary

Addresses

Primary practice location

200 Health Park Dr Ste 100
Garner, NC 27529-4679

Mailing address

200 Health Park Dr Ste 100
Garner, NC 27529-4679
Phone (919) 773-1223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221018003074 NC Practitioner - Physician Assistant 2668848599 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
George Washington University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Garner Internal Medicine, P.a.Group PAC ID 1355330721, 11 clinicians

Practice addresses (Care Compare)

200 Health Park Dr
Suite 100
Garner, NC 27529-6929
Phone (919) 773-1223

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: andrewkraska@gim.allscriptsdirect.net

Organizations & group practices 1

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": "1655424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1619608056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HEALTH PARK DR STE 100",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275294679",
            "telephone_number": "919-773-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HEALTH PARK DR STE 100",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275294679",
            "telephone_number": "919-773-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRASKA",
        "first_name": "ANDREW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-17",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garner, NC

Sources for this page

Verify at the official NPI Registry.