Active NPI
Elliot Kramer
- Specialist
- Corrales, NM
National Provider Identifier
1720416498
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 4550
- Practice address
- 565 Gutierrez Rd
Corrales, NM 87048-8467 - Phone
- (505) 301-3629
- NPI assigned
- Oct 16, 2013
- Last updated
- Oct 16, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 4550 | NM | Primary |
Addresses
Primary practice location
565 Gutierrez Rd
Corrales, NM 87048-8467
Mailing address
PO Box 3197
Corrales, NM 87048-3197
Phone (505) 301-3629
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4550 | NM | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1381881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1381881600000",
"number": "1720416498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3197",
"city": "CORRALES",
"state": "NM",
"postal_code": "870483197",
"telephone_number": "505-301-3629"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "565 GUTIERREZ RD",
"city": "CORRALES",
"state": "NM",
"postal_code": "870488467",
"telephone_number": "505-301-3629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRAMER",
"first_name": "ELLIOT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-10-16",
"last_updated": "2013-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NM",
"license": "4550",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corrales, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.