Active NPI
Daniel Robert Cronk, MD
- Vascular Surgery Physician
- Grand Island, NE
National Provider Identifier
1639101009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- 12658
- Practice address
- 820 N Alpha St
Grand Island, NE 68803-4320 - Phone
- (308) 384-7200
- Fax
- (308) 384-7378
- NPI assigned
- Jul 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | 12658 | NE | Primary |
| Surgery Physician | 208600000X | 12658 | NE |
Addresses
Primary practice location
820 N Alpha St
Grand Island, NE 68803-4320
Mailing address
PO Box 5226
Grand Island, NE 68802-5226
Phone (308) 384-7200
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31889 | Other | BLUE CROSS BLUE SHIELD NEBRASKA | |
| 020041733 | Other | NE | RAILROAD MEDICARE |
| 508060434 | Medicaid | NE |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12658 | NE | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Surgery Group of Grand Island | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Health Service Clinic/Center
- Grand Island, NE
- NPI 1457421471
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1275955200000",
"number": "1639101009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5226",
"city": "GRAND ISLAND",
"state": "NE",
"postal_code": "688025226",
"telephone_number": "308-384-7200",
"fax_number": "308-384-7378"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 N ALPHA ST",
"city": "GRAND ISLAND",
"state": "NE",
"postal_code": "688034320",
"telephone_number": "308-384-7200",
"fax_number": "308-384-7378"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRONK",
"first_name": "DANIEL",
"middle_name": "ROBERT",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2010-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "NE",
"license": "12658",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NE",
"license": "12658",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD NEBRASKA",
"identifier": "31889",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "020041733",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "508060434",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Island, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.