Individual provider Active NPI

Gregory Alexander Kraskowsky, O.D.

  • Optometrist
  • Alamo, CA
National Provider Identifier
1952440158
Registry record updated Aug 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11477 Issued in CA
Practice address
3201 Danville Blvd
Suite 165
Alamo, CA 94507-1938
Phone
(925) 820-6622
NPI assigned
Feb 5, 2007
Last updated
Aug 13, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11477 CA Primary

Addresses

Primary practice location

3201 Danville Blvd
Suite 165
Alamo, CA 94507-1938

Mailing address

3201 Danville Blvd
Suite 165
Alamo, CA 94507-1938

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20071004000658 CA Practitioner - Optometry 3375638497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3201 Danville Blvd
Suite 165
Alamo, CA 94507-1938
Phone (925) 820-6622

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kraskowsky Optometry, Inc. Optometrist CurrentSince Apr 10, 2017 Accepting new patients

Locations

3201 Danville Blvd
Ste 165
Alamo, CA 94507
Phone (925) 820-6622

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": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660348800000",
    "number": "1952440158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 DANVILLE BLVD",
            "address_2": "SUITE 165",
            "city": "ALAMO",
            "state": "CA",
            "postal_code": "945071938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 DANVILLE BLVD",
            "address_2": "SUITE 165",
            "city": "ALAMO",
            "state": "CA",
            "postal_code": "945071938",
            "telephone_number": "925-820-6622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRASKOWSKY",
        "first_name": "GREGORY",
        "middle_name": "ALEXANDER",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2022-08-13",
        "certification_date": "2022-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alamo, CA

Sources for this page

Verify at the official NPI Registry.