Adam J Kruse, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD-48450 Issued in IA

Practice address

4881 Sugar Maple Dr
Wpafb, OH 45433-5529

Phone

(937) 257-0770

NPI assigned

Mar 21, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• PHS Emergency Billing LLC

  • Emergency Medicine Physician
  • Dayton, OH
  • NPI 1578387486
  Medicare reassignment NPD

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

{
    "created_epoch": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1285138404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4881 SUGAR MAPLE DR",
            "city": "WPAFB",
            "state": "OH",
            "postal_code": "454335529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4881 SUGAR MAPLE DR",
            "city": "WPAFB",
            "state": "OH",
            "postal_code": "454335529",
            "telephone_number": "937-257-0770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSE",
        "first_name": "ADAM",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-21",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35.149945",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IA",
            "license": "MD-48450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mi Suke Kim, DMD
• Robert Monroe Kirby, DNP, CRNA
• Elizabeth Wanjiku Kiriri, MD
• Taylor R. Kjar, DO
• Tressa Kneer, R.PH.
• Derek Lapsins, RPH
• Alicia Marie Latta, DO
• Jake Laxer
• Charlotte Marie Lee, M.D.
• Jeffrey M Leisring, MD

• Emergency Medicine Physician in Wpafb, OH
• Providers in Wpafb, OH by specialty
• Emergency Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.