Individual provider Active NPI

Kathleen Letty Kruse, MD

  • Psychiatry Physician
  • Ann Arbor, MI
National Provider Identifier
1235511999
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
4301107635 Issued in MI
Practice address
1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Phone
(349) 364-0007
NPI assigned
Jun 18, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 35.139048 OH
Psychiatry Physician 2084P0800X 4301107635 MI Primary

Addresses

Primary practice location

1500 E Medical Center Dr
Ann Arbor, MI 48109-5000

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190117002077 MI Practitioner - Psychiatry 5799095824 Reassigns benefits to 2 organizations
I20210706003388 OH Practitioner - Psychiatry 5799095824 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph Mercy Hospital Current Accepting new patients
University Hospitals Medical Group Inc CurrentSince Aug 1, 2021 Accepting new patients
St Joseph Mercy Hospital CurrentSince Dec 12, 2018 Accepting new patients
Regents of the University of Michigan Psychiatry CurrentSince Aug 9, 2022 Accepting new patients
Regents of the University of Michigan CurrentSince Aug 9, 2022 Accepting new patients
St Joseph Mercy Hospital Clinical Neuropsychologist CurrentSince Dec 12, 2018 Accepting new patients

Locations

1500 E Medical Center Dr
#F6135
Ann Arbor, MI 48109
Phone (734) 615-0199

4250 Plymouth Rd
Ann Arbor, MI 48109
Phone (734) 764-0231

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

5361 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-1300

8055 Mayfield Rd
Ste 105
Chesterland, OH 44026
Phone (440) 214-8024

10524 Euclid Ave
#7135
Cleveland, OH 44106
Phone (216) 844-8749

11100 Euclid Ave
Cleveland Heights, OH 44106

Organizations & group practices 6

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": "1434585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1235511999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095000",
            "telephone_number": "349-364-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSE",
        "first_name": "KATHLEEN",
        "middle_name": "LETTY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-18",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35.139048",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301107635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.