Joel Krackow, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

MD011949E Issued in PA

Practice address

1 Medical Center Blvd
Pob II Suite 224
Upland, PA 19013

Phone

(610) 876-2400

Fax

(610) 876-4308

NPI assigned

Aug 26, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Southeast Radiology LTD

  • Diagnostic Radiology Physician
  • Chester, PA
  • NPI 1790779684
  NPD (past)

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207008000000",
    "number": "1649263443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 N BROAD ST",
            "address_2": "3RD FLR CARDIOLOGY CONSULTANTS OF PHILA PC",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "19107",
            "telephone_number": "215-462-7100",
            "fax_number": "215-463-3820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD",
            "address_2": "POB II SUITE 224",
            "city": "UPLAND",
            "state": "PA",
            "postal_code": "19013",
            "telephone_number": "610-876-2400",
            "fax_number": "610-876-4308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRACKOW",
        "first_name": "JOEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2008-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MD011949E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006844240006",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Akshita Khosla, MBBS
• Patricia Kidwell, CRNA
• Alice Soyoung Kim, MD
• Fnu Komaldeep Kaur, MD
• Pei Ann Kong, M.D.
• Carrie Kresge, MD
• Craig G Kriza, DPM
• Marsha Krouk, DO
• Glenn A. Ladinsky, M.D., PH.D.
• John P Lamond, MD

• Cardiovascular Disease Physician in Upland, PA
• Providers in Upland, PA by specialty
• Cardiovascular Disease Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; 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.