Individual provider Active NPI

Gary Alan Krosin, M.D.

  • Body Imaging Physician
  • Stuart, FL
National Provider Identifier
1942369210
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Body Imaging PhysicianTaxonomy code 2085B0100X
License
37516 Issued in FL
Practice address
2912 SW Trailside Path
Stuart, FL 34997-9013
Phone
(772) 285-7799
Fax
(772) 264-4602
NPI assigned
Dec 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X 37516 FL Primary

Addresses

Primary practice location

2912 SW Trailside Path
Stuart, FL 34997-9013

Mailing address

2912 SW Trailside Path
Stuart, FL 34997-9012
Phone (772) 285-7799

Other identifiers 1

IdentifierTypeStateIssuer
ME37516OtherFLMEDICAL LICENSE NUMBER

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
37516FLMDBody Imaging Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Imaging Services Inc Past Accepting new patients
Coastal Care Corporation Past Accepting new patients
Diagnostic Imaging Services Inc Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942369210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2912 SW TRAILSIDE PATH",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349979012",
            "telephone_number": "772-285-7799",
            "fax_number": "772-264-4602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2912 SW TRAILSIDE PATH",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349979013",
            "telephone_number": "772-285-7799",
            "fax_number": "772-264-4602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROSIN",
        "first_name": "GARY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "FL",
            "license": "37516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "ME37516",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.