Individual provider Active NPI

Tristan Kraft, M.D.

  • Pediatrics Physician
  • Detroit, MI
National Provider Identifier
1689961013
Registry record updated Jul 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301098442 Issued in MI
Practice address
3901 Beaubien St
Children'S Hospital of Michigan
Detroit, MI 48201-2119
Phone
(313) 745-1892
NPI assigned
Jul 6, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301098442 MI Primary

Addresses

Primary practice location

3901 Beaubien St
Children'S Hospital of Michigan
Detroit, MI 48201-2119

Mailing address

3901 Beaubien St
Children'S Hospital of Michigan
Detroit, MI 48201-2119

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20140624000306 MI Practitioner - Pediatric Medicine 5294959714 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301098442MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Pediatricians Pediatrics CurrentSince Jun 7, 2014 Accepting new patients
University Pediatricians Pediatrics CurrentSince Jun 7, 2014 Accepting new patients
William Beaumont Hospital Past Accepting new patients

Locations

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

4201 Saint Antoine St
Ste 226
Detroit, MI 48201
Phone (313) 966-2064

Interoperability endpoints

  • Direct secure messaging: tkraft1242348@epic00.shdirect.org

Organizations & group practices 3

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": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309910400000",
    "number": "1689961013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 BEAUBIEN ST",
            "address_2": "CHILDREN'S HOSPITAL OF MICHIGAN",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 BEAUBIEN ST",
            "address_2": "CHILDREN'S HOSPITAL OF MICHIGAN",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012119",
            "telephone_number": "313-745-1892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAFT",
        "first_name": "TRISTAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-06",
        "last_updated": "2011-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301098442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.