Calvin L Kruger II, P.A.
Individual provider Active NPI Physician Assistant · Pratt, KS
NPI 1326089558 · NPPES record last updated Mar 24, 2023
Key facts
- NPI
- 1326089558
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 1500632 (KS)
- Practice address
- 420 Country Club Rd
Pratt, KS 67124-3125 - Phone
- (620) 672-7415
- Fax
- (620) 672-7414
- NPI assigned
- Jun 9, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Pawnee Valley Community Hospital Inc
Practice addresses (Care Compare)
713 W 11TH St
Larned, KS 67550-2055
Phone (620) 804-6007
Hospital & facility affiliations
- Pratt Regional Medical Center
- Pawnee Valley Community Hospital
- Hospital District #6 Patterson Health Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050420001262 | KS | Practitioner - Physician Assistant | 9133167083 | Reassigns benefits to 6 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1500632 | KS | MD | Physician Assistant |
| 15-00632 | KS | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pratt Regional Medical Center Corporation | Current | Accepting new patients | |
| Trinity Medical Associates | Current | Accepting new patients | |
| Pratt Regional Medical Center Corporation | Current |
Accepting new patients | |
| Pratt Regional Medical Center Corporation | Current |
Accepting new patients | |
| Pawnee Valley Community Hospital, Inc. | Current |
Accepting new patients | |
| Ashland District Hospital | Current |
Accepting new patients | |
| Pawnee Valley Community Hospital, Inc. | Current |
Accepting new patients | |
| Ashland District Hospital | Current |
Accepting new patients | |
| Pawnee Valley Community Hospital Inc | Current |
Accepting new patients | |
| St. Joseph Memorial Hospital, Inc. | Past | Accepting new patients | |
| Pratt Internal Medicine Group PA | Past | Accepting new patients |
Locations
485 N KS Hwy 2
Anthony, KS 67003
Phone (620) 914-1200
625 Kentucky St
Ashland, KS 67831
Phone (620) 635-2222
625 Kentucky St
#188
Ashland, KS 67831
Phone (620) 635-2241
713 W 11th St
Larned, KS 67550
Phone (620) 285-6958
923 Carroll Ave
Larned, KS 67550
Phone (620) 285-3161
200 Commodore St
Pratt, KS 67124
Phone (620) 672-6476
420 Country Club Rd
Pratt, KS 67124
Phone (620) 672-7415
420 Country Club Rd
Ste 100
Pratt, KS 67124
Phone (620) 672-7415
Interoperability endpoints
- calvin.kruger@khindirect.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 15-00632 | KS | |
| Physician Assistant | 363A00000X | 1500632 | KS | Yes |
Addresses
Primary practice location
420 Country Club Rd
Pratt, KS 67124-3125
Mailing address
420 Country Club Rd
Pratt, KS 67124-3125
Phone (620) 672-7415
Other practice location 1
415 N Main St
Ulysses, KS 67880-2133
Phone (620) 356-1266
Other practice location 2
505 N Main St
Ulysses, KS 67880-2135
Phone (620) 356-1261
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100088840B | Medicaid | KS | |
| 2050536901 | Medicaid | KS |
Other providers in Pratt, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 24, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.