DR. MARCUS ROBERT KRET MD, NPI 1811158538 — PORTLAND (OR)

NPI 1811158538

11+ Years Experience Individual

DR. MARCUS ROBERT KRET MD

06/25/2008
PROVIDER ENUMERATION DATE
06/29/2016
LAST UPDATE DATE
1811158538
NPI NUMBER

About DR. MARCUS ROBERT KRET

Sole proprietor? No, Entity Type 1 Provider (Individual) is not a Sole Proprietor.

DR. MARCUS ROBERT KRET is a provider established in PORTLAND, OR. The NPI number of DR. MARCUS ROBERT KRET is 1811158538 and was assigned on 06/25/2008. The practitioners primary taxonomy code is: 2086S0129X with license number: DR0056645 CO .

Mailing address

  • City: DENVER
  • State: CO
  • Postal code: 802107000
  • Phone: 3037786527
  • Fax: 3037331288
  • Address: 950 E HARVARD AVE
  • Address 2: STE 550

Primary Practice Address

  • Region : PORTLAND, OR
  • NPI : 1811158538
  • Phone : 5034948211
  • Postalcode : 972393011
  • Address : 3181 SW SAM JACKSON PARK RD

Provider taxonomy - Surgery

  • Taxonomy code: 2086S0129X
  • License number: DR0056645
  • License state: CO

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy description: A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

Contacts:

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  • DR. MARCUS ROBERT KRET MD
  • Address : 3181 SW SAM JACKSON PARK RD
  • Region : PORTLAND, OR
  • NPI : 1811158538
  • Phone : 5034948211
  • Postalcode : 972393011

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address3181 SW SAM JACKSON PARK RD
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NamePORTLAND
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameOR
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code972393011
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number5034948211
The telephone number associated with the location address of the provider being identified.
NPI1811158538
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 12086S0129X
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
Provider Enumeration Date06/25/2008
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated06/29/2016
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)DR. MARCUS ROBERT KRET
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address950 E HARVARD AVE
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing AddressSTE 550
The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City NameDENVER
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameCO
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code802107000
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number3037786527
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number3037331288
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Healthcare Provider Taxonomy Code #12086S0129X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Surgery
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
Provider License Number 1DR0056645
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1CO
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Provider Gender CodeM
  • M - male
  • F - female
Is sole proprietorN
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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