NPIMap

Organization Active NPI

John E Kruger, O.D., P.C.

Doing business as Ames Eye Clinic

  • Optometrist
  • Ames, IA
National Provider Identifier
1336128651
Registry record updated Oct 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1623 Issued in IA
Legal business name
JOHN E KRUGER, O.D., P.C.
Doing business as
Ames Eye Clinic
Practice address
201 10TH St
Ames, IA 50010-6211
Phone
(515) 232-3451
Fax
(515) 233-4886
NPI assigned
Jan 13, 2006
Last updated
Oct 18, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2007

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

Authorized official

Name
John E. Kruger, O.D.NPI 1548253586
Title
President
Phone
(515) 232-3451

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1623 IA Primary

Addresses

Primary practice location

201 10TH St
Ames, IA 50010-6211

Mailing address

201 10TH St
P.O. Box 903
Ames, IA 50010-6211
Phone (515) 232-3451

Other identifiers 1

IdentifierTypeStateIssuer
0450262MedicaidIA

Other names 1

  • AMES EYE CLINIC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040524000493 IA Part B Supplier - Clinic/Group Practice 8729079181 Receives reassigned benefits from 2 practitioners
Practice locations: Ames, IA

National Provider Directory

National Provider Directory

Locations

201 10th St
Ames, IA 50010
Phone (515) 232-3451

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192665600000",
    "number": "1336128651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 10TH ST",
            "address_2": "P.O. BOX 903",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500106211",
            "telephone_number": "515-232-3451",
            "fax_number": "515-233-4886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 10TH ST",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500106211",
            "telephone_number": "515-232-3451",
            "fax_number": "515-233-4886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN E KRUGER, O.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-13",
        "last_updated": "2007-10-18",
        "status": "A",
        "authorized_official_last_name": "KRUGER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "515-232-3451",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "1623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0450262",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AMES EYE CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ames, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.