Ivan Krasnov, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A198433 Issued in CA

Practice address

127 Broadway Ste 100
Santa Monica, CA 90401-2389

Phone

(215) 955-8420

NPI assigned

Mar 29, 2019

Last updated

Oct 8, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1871054999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 BROADWAY STE 100",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904012389",
            "telephone_number": "310-340-6616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 BROADWAY STE 100",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904012389",
            "telephone_number": "215-955-8420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "833 Chestnut St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191074414",
            "country_code": "US",
            "telephone_number": "215-955-8420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRASNOV",
        "first_name": "IVAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-29",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A198433",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD479185",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harold Kraft, M.D.
• Andrea Krajisnik, MD
• Deborah Krakow, MD
• Jon Douglas Kramer, LCSW
• David Lowell Krasne, MD
• Robert M Krasny, MD
• Howard R Krauss, M.D.
• Elizabeth Mara Kraut, L.AC.,DIPL.O.M.
• Ashley Amber Kreger, PT
• Jennifer Marie Krekel, DPT

• Psychiatry Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; 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.