Individual provider Active NPI

Krzysztof Saraczewski, MD

  • Internal Medicine Physician
  • Savannah, GA
National Provider Identifier
1871082784
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
7189420 Issued in WI
Practice address
220 Duncan Dr
Savannah, GA 31409-5102
Phone
(912) 435-2737
NPI assigned
May 7, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training ProgramGroup: 193200000X MULTI-SPECIALTY GROUP 390200000X 71894-20 WI
Internal Medicine Physician 207R00000X 7189420 WI Primary

Addresses

Primary practice location

220 Duncan Dr
Savannah, GA 31409-5102

Mailing address

258 Garfield Ave Apt B
Collingswood, NJ 08108-3828
Phone (856) 701-8556

Other practice location 1

300 East Hospital Road
Fort Gordon, GA 30905-5650
Phone (706) 787-1745

Other identifiers 1

IdentifierTypeStateIssuer
71894-20OtherWILICENSE

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
7189420WIMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1525651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1871082784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 GARFIELD AVE APT B",
            "city": "COLLINGSWOOD",
            "state": "NJ",
            "postal_code": "081083828",
            "telephone_number": "856-701-8556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 DUNCAN DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314095102",
            "telephone_number": "912-435-2737"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 East Hospital Road",
            "address_purpose": "LOCATION",
            "city": "Fort Gordon",
            "state": "GA",
            "postal_code": "309055650",
            "country_code": "US",
            "telephone_number": "706-787-1745",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SARACZEWSKI",
        "first_name": "KRZYSZTOF",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-07",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WI",
            "license": "71894-20",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "7189420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "71894-20",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2022; 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.