Evelyn Kraut, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25MA04282800 Issued in NJ

Practice address

18 Railroad Ave
Suite 103
Rochelle Park, NJ 07662-4105

Phone

(201) 928-0748

Fax

(201) 291-2328

NPI assigned

Aug 17, 2005

Sex

Female

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

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358726400000",
    "number": "1669464657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 RAILROAD AVE",
            "city": "ROCHELLE PARK",
            "state": "NJ",
            "postal_code": "076624105",
            "telephone_number": "201-291-2323",
            "fax_number": "201-291-2328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 RAILROAD AVE",
            "address_2": "SUITE 103",
            "city": "ROCHELLE PARK",
            "state": "NJ",
            "postal_code": "076624105",
            "telephone_number": "201-928-0748",
            "fax_number": "201-291-2328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAUT",
        "first_name": "EVELYN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-17",
        "last_updated": "2013-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA04282800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "388505",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul Keshishian, D.O.
• Rashid Ildar Khalid, D.M.D
• Roman Khodik, LAC, MA
• Jennifer A King, LCSW
• Stacey Marie Kirchner Glanz, MSW LCSW
• Paul Jude Lama, M.D.
• Ashley Langston, BCBA
• Sarah Laranjeiro, LCSW
• Moiz Latif
• Jason Leiken

• Pediatrics Physician in Rochelle Park, NJ
• Providers in Rochelle Park, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.