Individual provider Active NPI

Aleksandr Kruchakov, AP, MA

  • Acupuncturist
  • Hollywood, FL
National Provider Identifier
1942345806
Registry record updated Feb 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AP1714 Issued in FL
Practice address
1531 N Federal Hwy
Hollywood, FL 33020-2849
Phone
(954) 922-1270
Fax
(954) 922-1273
NPI assigned
Feb 20, 2007
Last updated
Feb 7, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AP1714 FL Primary
Massage Therapist 225700000X MA 21878 FL

Addresses

Primary practice location

1531 N Federal Hwy
Hollywood, FL 33020-2849

Mailing address

2851 NE 183Rd St
Apt. 1603
Aventura, FL 33160-2104
Phone (954) 536-9231

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)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
AP1714FLMDAcupuncturist
MA 21878FLMDMassage Therapist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202342400000",
    "number": "1942345806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2851 NE 183RD ST",
            "address_2": "APT. 1603",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331602104",
            "telephone_number": "954-536-9231",
            "fax_number": "305-893-5208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1531 N FEDERAL HWY",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330202849",
            "telephone_number": "954-922-1270",
            "fax_number": "954-922-1273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUCHAKOV",
        "first_name": "ALEKSANDR",
        "name_prefix": "Mr.",
        "credential": "AP, MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2008-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "FL",
            "license": "AP1714",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA 21878",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; 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.