Ted Henry Kruse, DPT, CSCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

03764 Issued in IA

Practice address

1129 11TH St SE
Suite a
Dyersville, IA 52040-2050

Phone

(563) 875-8615

Fax

(563) 875-8722

NPI assigned

Nov 9, 2006

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 IA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jason J. Putz Physical Therapy P.C.Group PAC ID 2769578657, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Jason J. Putz Physical Therapy P.C.

  • Physical Therapy Clinic/Center
  • Dyersville, IA
  • NPI 1306033568
  Medicare reassignment Care Compare group NPD
• Eastern Iowa Therapeutics PC

  • Physical Therapist
  • Chicago, IL
  • NPI 1023064144
  NPD (past)

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478649600000",
    "number": "1306916754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 11TH ST SE",
            "address_2": "SUITE A",
            "city": "DYERSVILLE",
            "state": "IA",
            "postal_code": "520402050",
            "telephone_number": "563-875-8615",
            "fax_number": "563-875-8722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 11TH ST SE",
            "address_2": "SUITE A",
            "city": "DYERSVILLE",
            "state": "IA",
            "postal_code": "520402050",
            "telephone_number": "563-875-8615",
            "fax_number": "563-875-8722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSE",
        "first_name": "TED",
        "middle_name": "HENRY",
        "credential": "DPT, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2016-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "03764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "38593",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Marie Jarosz, DPT
• Jason J. Putz Physical Therapy P.C.
• Jeffrey Klein, DPM
• Jordynne Lei Knipper, DPT
• Julie Koch - Womer, D.D.S.
• Kvbdcpc
• Holly Lieurance, DPT
• Martin Brothers Chiropractic PLLC
• Daniel Frederick Martin, D.C.
• Thomas Joseph Martin, DC

• Physical Therapist in Dyersville, IA
• Providers in Dyersville, IA by specialty
• Physical Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.