Kenneth Edward Kruczek, D.O

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

E6120 Issued in TX

Practice address

3506 21St St
Suite 605
Lubbock, TX 79410-1212

Phone

(806) 725-4130

Fax

(806) 723-7137

NPI assigned

May 23, 2005

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 3

Medicare fee-for-service enrollment

Enrolled in TX

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 Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kkruczek@yourcarecommunity.org

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.

• Cogent Healthcare of Texas, PA

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1992722953
  Medicare reassignment NPD
• Hospitalist Medicine Physicians of Texas, PLLC

  • Internal Medicine Physician
  • Humble, TX
  • NPI 1629307095
  Medicare reassignment NPD
• Sound Inpatient Physicians of Texas I, Inc

  • Family Medicine Physician
  • Sugar Land, TX
  • NPI 1831424563
  Medicare reassignment
• Grace Clinic of Lubbock

  dba Expresscare Virtual

  • Multi-Specialty Clinic/Center
  • Lubbock, TX
  • NPI 1770237042
  NPD (past)

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318809600000",
    "number": "1306849419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 22ND PL",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101314",
            "telephone_number": "806-725-5844",
            "fax_number": "806-723-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3506 21ST ST",
            "address_2": "SUITE 605",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101212",
            "telephone_number": "806-725-4130",
            "fax_number": "806-723-7137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUCZEK",
        "first_name": "KENNETH",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2011-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "E6120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "034876502",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000Q2634",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TX",
            "identifier": "8CT089",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristi Hosek, Inc
• Alexander Kroll, MD
• Tobias Alf Kroll, PHD, CCC-SLP
• Alexis Windsor Kropf, MD
• Christine Martin Kroyer-Haggard, M.ED.
• Branda L Kruger, NNP
• Ashley Kuehl, LCSW
• James Edward Kuehl III, LMSW
• Kui Medical Services PLLC
• Robyn Rachelle Kuiper, MA, LPC

• Internal Medicine Physician in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2011; 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.