Individual provider Active NPI

Rostislav Krasnov, D.D.S.

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1942267935
Registry record updated Dec 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
008698 Issued in CT
Practice address
330 W 42ND St
New York, NY 10036-6902
Phone
(212) 631-0222
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 046043 NY
General Practice Dentistry 1223G0001X 008698 CT Primary
Dentist 122300000X DS038562 PA
Dentist 122300000X 27827 TX

Addresses

Primary practice location

330 W 42ND St
New York, NY 10036-6902

Mailing address

330 W 42ND St
New York, NY 10036-6902
Phone (212) 631-0222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150918002577 NY Order and Referring Only - DentistPractitioner - Dentist 1557678869

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS038562PAMDDentist
27827TXMDDentist
008698CTMDGeneral Practice Dentistry
046043NYMDPharmacist

Networks

  • HealthSun Health Plans Network
  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451520000000",
    "number": "1942267935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 W 42ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100366902",
            "telephone_number": "212-631-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 W 42ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100366902",
            "telephone_number": "212-631-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRASNOV",
        "first_name": "ROSTISLAV",
        "name_prefix": "Mr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2015-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "046043",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "008698",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS038562",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "27827",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.