Individual provider Active NPI

Jeffrey J Kroll, MD

  • Dermatology Physician
  • Coral Springs, FL
National Provider Identifier
1669435913
Registry record updated Aug 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME20164 Issued in FL
Practice address
3000 University Drive
Coral Springs, FL 33065
Phone
(954) 752-2630
Fax
(954) 752-9391
NPI assigned
Apr 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X ME20164 FL Primary

Addresses

Primary practice location

3000 University Drive
Coral Springs, FL 33065

Mailing address

3000 University Drive
St K Dermatology Consultants of S FL PA
Coral Springs, FL 33065
Phone (954) 752-2630

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME20164FLMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Skin and Cancer Associates Dermatology PastSince Mar 17, 2014 Accepting new patients
Dermatology Consultants of S FL PA Dermatology Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/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": "1144454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377043200000",
    "number": "1669435913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 UNIVERSITY DRIVE",
            "address_2": "ST K DERMATOLOGY CONSULTANTS OF S FL PA",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "33065",
            "telephone_number": "954-752-2630",
            "fax_number": "954-752-9391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 UNIVERSITY DRIVE",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "33065",
            "telephone_number": "954-752-2630",
            "fax_number": "954-752-9391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROLL",
        "first_name": "JEFFREY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-08",
        "last_updated": "2013-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME20164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2013; 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.