MEDICARE: JACOB KRAUSE PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AS0400X	Surgical Physician Assistant	PA06868	TX
2	390200000X	Student in an Organized Health Care Education/Training Program
3	363A00000X	Physician Assistant	0003542	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	827N58	OTHER	TX	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073827820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACOB KRAUSE PA

Provider Business Mailing Address
First Line	:	700 DELAWARE ST
Second Line	:	2ND FLOOR, NORTH TOWER
City	:	DENVER
State	:	CO
Zip	:	80204-4532
Country	:	US
Telephone Number	:	303-602-7600
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 DELAWARE ST
Second Line	:	2ND FLOOR, NORTH TOWER
City	:	DENVER
State	:	CO
Zip	:	80204-4532
Country	:	US
Telephone Number	:	303-602-7600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2010
Last Update Date	:	06/15/2026

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