NPIMap

Individual provider Active NPI

Mark R Krakovitz, MD

  • Diagnostic Radiology Physician
  • Williston, ND
National Provider Identifier
1922046242
Registry record updated Nov 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
12550 Issued in ND
Practice address
1301 15TH Ave. W.
Williston, ND 58801-3821
Phone
(701) 774-7435
Fax
(701) 774-7479
NPI assigned
Jun 2, 2006
Last updated
Nov 13, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2012

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Medicine Physician 207U00000X MD033369E PA
Nuclear Medicine Physician 207U00000X 25MA05265300 NJ
Diagnostic Radiology Physician 2085R0202X MD033369E PA
Diagnostic Radiology Physician 2085R0202X ME112875 FL
Diagnostic Radiology Physician 2085R0202X 25MA05265300 NJ
Diagnostic Radiology Physician 2085R0202X 12550 ND Primary

Addresses

Primary practice location

1301 15TH Ave. W.
Williston, ND 58801-3821

Mailing address

3265 NW 87TH Ave.
Miami, FL 33172
Phone (952) 595-1301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, FL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040301000622 PA Practitioner - Diagnostic Radiology 4183511611 Reassigns benefits to 1 organization
I20121105000608 FL Practitioner - Diagnostic RadiologyPractitioner - Nuclear MedicinePractitioner - Peripheral Vascular DiseasePractitioner - Interventional Radiology 4183511611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical College of Pennsylvania, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trumbull Radiologists IncGroup PAC ID 1951393057, 21 clinicians

Practice addresses (Care Compare)

740 E State St
Sharon, PA 16146-3328
Phone (614) 570-9233

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Medical Imaging Services Inc Diagnostic Radiology CurrentSince Nov 7, 2014 Accepting new patients
Progressive Diagnostic Imaging, LLC Diagnostic Radiology CurrentSince Oct 1, 2018 Accepting new patients
Trumbull Radiologists Inc Diagnostic Radiology CurrentSince Oct 22, 2022 Accepting new patients
Advanced Imaging Mobile Ultrasound Services CurrentSince Nov 1, 2023 Accepting new patients
Garden State Healthcare Associates, LLC CurrentSince Nov 28, 2018 Accepting new patients
Hudson Hospital Opco LLC Current Accepting new patients
Diagnostic Imaging Inc Diagnostic Radiology Past Accepting new patients
Trinity Imaging Associates, P.C. Diagnostic Radiology Past Accepting new patients
Mercy Diagnostic Imaging PC Diagnostic Radiology Past Accepting new patients
Addus Incorporated PastSince Aug 10, 2023 Accepting new patients
Diagnostic Imaging of South Jersey PC Diagnostic Radiology Past Accepting new patients
Northeast Imaging Associates of Philadelphia, P.C. Diagnostic Radiology Past Accepting new patients

Locations

2601 E Oakland Park Blvd
Ste 102
Ft Lauderdale, FL 33306

9360 River Rd
Marcy, NY 13403

810 S Main St
Akron, OH 44311
Phone (330) 480-2502

740 E State St
Sharon, PA 16146
Phone (724) 983-1980

Interoperability endpoints

  • Direct secure messaging: mark.krakovitz@direct.christhospital.md

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352764800000",
    "number": "1922046242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3265 NW 87TH AVE.",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33172",
            "telephone_number": "952-595-1301",
            "fax_number": "952-942-3361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 15TH AVE. W.",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588013821",
            "telephone_number": "701-774-7435",
            "fax_number": "701-774-7479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAKOVITZ",
        "first_name": "MARK",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2012-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "PA",
            "license": "MD033369E",
            "primary": false
        },
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "NJ",
            "license": "25MA05265300",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD033369E",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME112875",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MA05265300",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ND",
            "license": "12550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williston, ND

Sources for this page

Verify at the official NPI Registry.