Active NPI
Steven L Karassik, MD
- Dermatology Physician
- Ketchum, ID
National Provider Identifier
1891748117
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- M5900
- Practice address
- 191 W 5TH St
Ketchum, ID 83340 - Phone
- (208) 725-2171
- NPI assigned
- May 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | M5900 | ID | Primary |
| Dermatopathology Physician | 207ND0900X | M5900 | ID |
Addresses
Primary practice location
191 W 5TH St
Ketchum, ID 83340
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-2222
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
| License | State | Type | Specialty |
|---|---|---|---|
| M5900 | ID | MD | Dermatopathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379980800000",
"number": "1891748117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 E BANNOCK ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837126241",
"telephone_number": "208-381-2222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "191 W 5TH ST",
"city": "KETCHUM",
"state": "ID",
"postal_code": "83340",
"telephone_number": "208-725-2171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KARASSIK",
"first_name": "STEVEN",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-18",
"last_updated": "2013-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "ID",
"license": "M5900",
"primary": true
},
{
"code": "207ND0900X",
"taxonomy_group": "",
"desc": "Dermatology, Dermatopathology",
"state": "ID",
"license": "M5900",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ketchum, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.