Erik Thomas Krueger, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11755 Issued in MN

Practice address

2665 W 78TH St
Chanhassen, MN 55317-4502

Phone

(952) 835-4512

Fax

(888) 425-0398

NPI assigned

Dec 23, 2019

Last updated

Aug 4, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Shakopee Mdewakanton Sioux Community

  dba Shakopee Dakota Clinic

  • Family Medicine Physician
  • Prior Lake, MN
  • NPI 1013933381
  Medicare reassignment NPD

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

{
    "created_epoch": "1577059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1215576145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7825 3RD ST N",
            "address_2": "STE 105",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551285444",
            "telephone_number": "952-835-4512",
            "fax_number": "888-425-0398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2665 W 78TH ST",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "553174502",
            "telephone_number": "952-835-4512",
            "fax_number": "888-425-0398"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "340 State Highway 7",
            "address_purpose": "LOCATION",
            "city": "Excelsior",
            "state": "MN",
            "postal_code": "553313008",
            "country_code": "US",
            "telephone_number": "952-835-4512",
            "fax_number": "888-425-0398",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "ERIK",
        "middle_name": "THOMAS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-23",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "11755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTUM PROVIDER ID",
            "identifier": "158566",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mary Jeffery Kuhn
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• Christine Frances Lager, PT, DPT
• Michael Dennis Lano, MD
• Nicholas Larson, D.C.

• Physical Therapist in Chanhassen, MN
• Providers in Chanhassen, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.