Individual provider Active NPI

Calvin L Kruger II, P.A.

  • Physician Assistant
  • Pratt, KS
National Provider Identifier
1326089558
Registry record updated Mar 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1500632 Issued in KS
Practice address
420 Country Club Rd
Pratt, KS 67124-3125
Phone
(620) 672-7415
Fax
(620) 672-7414
NPI assigned
Jun 9, 2006
Last updated
Mar 24, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 15-00632 KS
Physician Assistant 363A00000X 1500632 KS Primary

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

505 N Main St
Ulysses, KS 67880-2135
Phone (620) 356-1261

Other practice location 2

415 N Main St
Ulysses, KS 67880-2133
Phone (620) 356-1266

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050420001262 KS Practitioner - Physician Assistant 9133167083 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pawnee Valley Community Hospital IncGroup PAC ID 7315856473, shared by 5 NPIs, 11 clinicians

Practice addresses (Care Compare)

713 W 11TH St
Larned, KS 67550-2055
Phone (620) 804-6007

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1500632KSMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ashland District Hospital CurrentSince Jan 1, 2023 Accepting new patients
Trinity Medical Associates Current Accepting new patients
Pawnee Valley Community Hospital, Inc. CurrentSince Jun 1, 2016 Accepting new patients
Pratt Regional Medical Center Corporation CurrentSince Apr 27, 2010 Accepting new patients
Pratt Regional Medical Center Corporation CurrentSince Apr 27, 2010 Accepting new patients
Pawnee Valley Community Hospital Inc CurrentSince Nov 21, 2016 Accepting new patients
Pratt Internal Medicine Group PA Past Accepting new patients
St. Joseph Memorial Hospital, Inc. Past Accepting new patients
Pawnee Valley Community Hospital, Inc Past Accepting new patients

Locations

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

  • Direct secure messaging: calvin.kruger@khindirect.org

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679616000000",
    "number": "1326089558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 COUNTRY CLUB RD",
            "city": "PRATT",
            "state": "KS",
            "postal_code": "671243125",
            "telephone_number": "620-672-7415",
            "fax_number": "620-672-7414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 COUNTRY CLUB RD",
            "city": "PRATT",
            "state": "KS",
            "postal_code": "671243125",
            "telephone_number": "620-672-7415",
            "fax_number": "620-672-7414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 N Main St",
            "address_purpose": "LOCATION",
            "city": "Ulysses",
            "state": "KS",
            "postal_code": "678802135",
            "country_code": "US",
            "telephone_number": "620-356-1261",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "415 N Main St",
            "address_purpose": "LOCATION",
            "city": "Ulysses",
            "state": "KS",
            "postal_code": "678802133",
            "country_code": "US",
            "telephone_number": "620-356-1266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRUGER",
        "first_name": "CALVIN",
        "middle_name": "L",
        "name_suffix": "II",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KS",
            "license": "15-00632",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "1500632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pratt, KS

Sources for this page

Verify at the official NPI Registry.