Stephen J Kruljac, D.P.M., P.C.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

SC002458L Issued in PA

Legal business name

STEPHEN J KRULJAC, D.P.M., P.C.

Practice address

495 East Waterfront Drive
Suite 230
Homestead, PA 15120-1151

Phone

(412) 461-1108

Fax

(412) 461-5490

NPI assigned

Jan 11, 2008

Organization subpart

No

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

Authorized official

Name

Stephen J Kruljac, D.P.M.NPI 1861464836

Title

Owner

Phone

(412) 461-1108

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stephen J Kruljac, DPM

  • Foot & Ankle Surgery Podiatrist
  • Homestead, PA
  • NPI 1861464836
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389139200000",
    "number": "1225214968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 EAST WATERFRONT DRIVE",
            "address_2": "SUITE 230",
            "city": "HOMESTEAD",
            "state": "PA",
            "postal_code": "151201151",
            "telephone_number": "412-461-1108",
            "fax_number": "412-461-5490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 EAST WATERFRONT DRIVE",
            "address_2": "SUITE 230",
            "city": "HOMESTEAD",
            "state": "PA",
            "postal_code": "151201151",
            "telephone_number": "412-461-1108",
            "fax_number": "412-461-5490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN J KRULJAC, D.P.M., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-11",
        "last_updated": "2014-01-08",
        "status": "A",
        "authorized_official_last_name": "KRULJAC",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "412-461-1108",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC002458L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MC GROUP PROVIDER NUMBER",
            "identifier": "100960XXT",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MC GROUP NPI NUMBER",
            "identifier": "1225214968",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI NUMBER",
            "identifier": "1225214968",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE LEGACY NUMBER",
            "identifier": "100960",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480009776",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009128330001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Homestead, PA
• Providers in Homestead, PA by specialty
• Foot & Ankle Surgery Podiatrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2014; 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.