NPIMap

Individual provider Active NPI

Eric Krutel, D.O.

  • Internal Medicine Physician
  • Detroit, MI
National Provider Identifier
1144773284
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5101025983 Issued in MI
Practice address
22201 Moross Rd Ste 170
Detroit, MI 48236-2152
Phone
(313) 886-8787
NPI assigned
Jul 25, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101025983 MI Primary

Addresses

Primary practice location

22201 Moross Rd Ste 170
Detroit, MI 48236-2152

Mailing address

22201 Moross Rd Ste 170
Detroit, MI 48236-2152
Phone (313) 886-8787

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210301000808 MI Practitioner - Nephrology 3375837099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Lake Erie College of Osteopathic Medicine, Erie, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Clair Specialty Physicians PCGroup PAC ID 6204733256, 36 clinicians

Practice addresses (Care Compare)

18001 E 10 Mile Rd
Roseville, MI 48066-3803
Phone (586) 871-3686

Hospital & facility affiliations

  • DaVita Grosse Pointe Dialysis Dialysis facility, Detroit, MI, CCN 232643
  • Fresenius Dialysis Services of Shelby Dialysis facility, Shelby Township, MI, CCN 232627
  • DaVita Macomb Kidney Center Dialysis facility, Warren, MI, CCN 232540
  • DaVita East China Dialysis Dialysis facility, East China, MI, CCN 232718
  • Beaumont Hospital - Grosse Pointe Hospital, Grosse Pointe, MI, CCN 230089
  • McLaren Macomb Hospital, Mount Clemens, MI, CCN 230227
  • Henry Ford Macomb Hospital Hospital, Clinton Township, MI, CCN 230047
  • McLaren Port Huron Hospital, Port Huron, MI, CCN 230216
  • Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101025983MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Clair Specialty Physicians PC Nephrology CurrentSince Feb 26, 2021 Accepting new patients
Idaho Nephrology Associates, L.L.C Nephrology Past Accepting new patients

Locations

22201 Moross Rd
Ste 170
Detroit, MI 48236
Phone (313) 886-8787

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

1000 Harrington St
Mount Clemens, MI 48043
Phone (586) 493-3727

18001 E 10 Mile Rd
Ste 1
Roseville, MI 48066
Phone (586) 218-5800

18001 E 10 Mile Rd
Ste 3
Roseville, MI 48066

18001 E 10 Mile Rd
Roseville, MI 48066

23857 Greenfield Rd
Southfield, MI 48075
Phone (248) 569-6111

45640 Schoenherr Rd
Ste B
Utica, MI 48315
Phone (586) 247-4300

45650 Schoenherr Rd
Utica, MI 48315
Phone (586) 286-7800

Interoperability endpoints

  • Direct secure messaging: erickrutel@stclairspe.allscriptsdirect.net
  • Direct secure messaging: ekrutel739790@direct.hfhs.org

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 and National Provider Directory roles.

Hospital & facility affiliations 10

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": "1469404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1144773284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22201 MOROSS RD STE 170",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362152",
            "telephone_number": "313-886-8787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22201 MOROSS RD STE 170",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362152",
            "telephone_number": "313-886-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUTEL",
        "first_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-25",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101025983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.