Individual provider Active NPI

Katie May Krueger, PA-C

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1144533464
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA06766 Issued in TX
Practice address
18152 Preston Rd Ste I-2
Dallas, TX 75252-5427
Phone
(469) 200-2832
Fax
(469) 269-1074
NPI assigned
Jul 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA06766 TX
Physician Assistant 363A00000X PA06766 TX Primary

Addresses

Primary practice location

18152 Preston Rd Ste I-2
Dallas, TX 75252-5427

Mailing address

18152 Preston Rd Ste I-2
Dallas, TX 75252-5427
Phone (469) 200-2832

Other identifiers 1

IdentifierTypeStateIssuer
P00871043OtherTXRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20101102001107 TX Practitioner - Physician Assistant 4688868730 Reassigns benefits to 1 organization
I20120109000756 CO Practitioner - Physician Assistant 4688868730

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1279152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1144533464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18152 PRESTON RD STE I-2",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752525427",
            "telephone_number": "469-200-2832",
            "fax_number": "469-269-1074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18152 PRESTON RD STE I-2",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752525427",
            "telephone_number": "469-200-2832",
            "fax_number": "469-269-1074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "KATIE",
        "middle_name": "MAY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-15",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA06766",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA06766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00871043",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.