Individual provider Active NPI

Elena Mihaela Kruse, CRNP

  • Family Nurse Practitioner
  • Huntsville, AL
National Provider Identifier
1003422742
Registry record updated Sep 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
125979 Issued in AL
Practice address
415 Echurch St
NW Suite 4
Huntsville, AL 35801
Phone
(256) 489-0757
NPI assigned
Sep 18, 2020
Last updated
Sep 18, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 125979 AL Primary

Addresses

Primary practice location

415 Echurch St
NW Suite 4
Huntsville, AL 35801

Mailing address

828 Old Cove Road
Owens Cross Roads, AL 35763
Phone (903) 293-3453

Other identifiers 1

IdentifierTypeStateIssuer
NAOtherPENDING

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL Huntsville Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201202000459 AL Practitioner - Nurse Practitioner 3476964164 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Zaheer a Khan MD PCGroup PAC ID 1456662832, 3 clinicians

Practice addresses (Care Compare)

3007 Memorial Swpkwy B
Huntsville, AL 35801-5394
Phone (256) 799-2500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.42 of 100Reported as individual
Quality
98.84
Improvement activities
40
Cost
82.96

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
125979ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke Integrative Medical Center Inc Single Specialty CurrentSince Sep 8, 2020 Accepting new patients
Zaheer a Khan MD PC Single Specialty CurrentSince Oct 22, 2020 Accepting new patients

Locations

3007 Memorial Pkwy SW
Ste B
Huntsville, AL 35801
Phone (256) 799-2500

415E Church St NW
Ste 4
Huntsville, AL 35801
Phone (256) 801-4536

929 Willowbrook Dr SE
Ste D
Huntsville, AL 35802
Phone (210) 482-9140

Interoperability endpoints

  • Direct secure messaging: elena.kruse@cfe.direct.medconnecthealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1600387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1003422742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "828 OLD COVE ROAD",
            "city": "OWENS CROSS ROADS",
            "state": "AL",
            "postal_code": "35763",
            "telephone_number": "903-293-3453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 ECHURCH ST",
            "address_2": "NW SUITE 4",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "35801",
            "telephone_number": "256-489-0757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSE",
        "first_name": "ELENA",
        "middle_name": "MIHAELA",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-18",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "125979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENDING",
            "identifier": "NA",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Huntsville",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "415 ECHURCH ST",
            "address_2": "NW SUITE 4",
            "city": "HUNTSVILLE",
            "state": "AL",
            "country_code": "US",
            "postal_code": "35801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.