Individual provider Active NPI

Sarah Elizabeth Kruse, OD

  • Optometrist
  • Edwardsville, IL
National Provider Identifier
1184370124
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2022005710 Issued in MO
Practice address
6620 Center Grove Rd
Edwardsville, IL 62025-2802
Phone
(618) 659-1900
NPI assigned
Feb 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2022005710 MO Primary

Addresses

Primary practice location

6620 Center Grove Rd
Edwardsville, IL 62025-2802

Mailing address

1708 Meadow LN
Edwardsville, IL 62025-3948

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221005002404 IL Practitioner - Optometry 1557747151 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metro Eye Care PCGroup PAC ID 0244256014, 5 clinicians

Practice addresses (Care Compare)

6620 Ctr Grove Rd
Edwardsville, IL 62025-2802
Phone (618) 659-1900

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2022005710MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Eye Care PC Optometrist CurrentSince Sep 19, 2022 Accepting new patients

Locations

6620 Center Grove Rd
#3
Edwardsville, IL 62025

6620 Center Grove Rd
Edwardsville, IL 62025
Phone (618) 659-1900

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": "1646006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1184370124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 MEADOW LN",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620253948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6620 CENTER GROVE RD",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620252802",
            "telephone_number": "618-659-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSE",
        "first_name": "SARAH",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-28",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2022005710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edwardsville, IL

Sources for this page

Verify at the official NPI Registry.