Derek Gene Kroll, DO

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

125063639 Issued in IL

Practice address

500 Medical Center Blvd
Conroe, TX 77304-2889

Phone

(281) 719-9681

NPI assigned

Jun 12, 2013

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

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

Specialty

Neurosurgery

Education

University of North Texas HSC, College of Osteopathic Med, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Specialty Associates of West Houston PLLCGroup PAC ID 6800056177, 125 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Houston Healthcare Conroe Hospital, Conroe, TX, CCN 450222
• Aspire Hospital Hospital, Conroe, TX, CCN 670093

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: derek.kroll@hca9.eclinicaldirectplus.com

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.

• Specialty Associates of West Houston PLLC

  • Internal Medicine Physician
  • Houston, TX
  • NPI 1699062349

  TX

  Medicare reassignment Care Compare group NPD
• Orthopaedic Associates, LLP

  • Orthopaedic Surgery Physician
  • Houston, TX
  • NPI 1841276631
  NPD (past)

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

• Aspire Hospital, LLC

  • Psychiatric Hospital
  • Conroe, TX
  • NPI 1093955296

  Hospital

  Care Compare affiliation
• Aspire Hospital, LLC

  • General Acute Care Hospital
  • Conroe, TX
  • NPI 1114340080

  Hospital

  Care Compare affiliation
• Chca Conroe LP

  • General Acute Care Hospital
  • Conroe, TX
  • NPI 1962455816

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1326486283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 FRANKLIN AVE",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613558",
            "telephone_number": "309-454-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MEDICAL CENTER BLVD",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042889",
            "telephone_number": "281-719-9681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROLL",
        "first_name": "DEREK",
        "middle_name": "GENE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-12",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IL",
            "license": "125063639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Theodore John Krzysik, MSN, APRN, FNP-BC
• Mary Lael Kucera, PA
• Tyler Lee Kucera

• All providers in Conroe, TX
• Neurological Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; 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.
• 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.