Individual provider Active NPI

Peter G. Kruk, M.D.

  • Pediatric Radiology Physician
  • San Diego, CA
National Provider Identifier
1366480634
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
License
A96070 Issued in CA
Practice address
3020 Childrens Way
San Diego, CA 92123-4223
Phone
(858) 576-1700
NPI assigned
Jun 2, 2006
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Radiology Physician 2085P0229X A96070 CA Primary
Neuroradiology Physician 2085N0700X A96070 CA

Addresses

Primary practice location

3020 Childrens Way
San Diego, CA 92123-4223

Mailing address

3020 Childrens Way
Mc5003
San Diego, CA 92123-4223
Phone (858) 576-1700

Other practice location 1

8745 Aero Dr
Suite 200
San Diego, CA 92123-1761
Phone (858) 565-0950

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20060928000277 CA Practitioner - Diagnostic Radiology 6103821020 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Indiana University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wishon Radiological Medical Group IncGroup PAC ID 8022065036, 13 clinicians
San Diego Imaging-Chula Vista LLCGroup PAC ID 5496641813, 43 clinicians

Practice addresses (Care Compare)

13419 Glencliff Way
San Diego, CA 92130-1313
Phone (559) 353-3000

250 Prospect PL
Coronado, CA 92118-1943
Phone (619) 522-3721

3020 Children's Way
San Diego, CA 92123-4223
Phone (858) 966-5861

3075 Health Ctr Dr
San Diego, CA 92123-2773
Phone (858) 939-5100

751 Med Ctr CT
Chula Vista, CA 91911-6617
Phone (619) 482-3639

765 Medical Ctr CT
Chula Vista, CA 91911-6600
Phone (619) 397-6577

7901 Frost St
San Diego, CA 92123-2701
Phone (858) 939-3600

7910 Frost St
Suite 100
San Diego, CA 92123-2776
Phone (858) 634-5900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.75 of 100Reported as group
Quality
100
Improvement activities
40
Cost
72.17

Merit-based Incentive Payment System (MIPS)

Final score
90.08 of 100Reported as group
Quality
82.75
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A96070CAMDNeuroradiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Diego Diagnostic Radiology Medical Group, Inc. CurrentSince Aug 14, 2006 Accepting new patients
San Diego Diagnostic Radiology Medical Group Inc Body Imaging Current Accepting new patients
Scripps Health Current Accepting new patients
Wishon Radiological Medical Group, Inc. Pediatric Radiology CurrentSince Oct 13, 2023 Accepting new patients
Regents of the University of California Body Imaging CurrentSince Nov 16, 2006 Accepting new patients
San Diego Diagnostic Radiology Medical Group, Inc. Body Imaging CurrentSince Aug 14, 2006 Accepting new patients
San Diego Imaging-Chula Vista LLC CurrentSince Jun 5, 2006 Accepting new patients
San Diego Imaging, LLC CurrentSince Mar 1, 2023 Accepting new patients
San Diego Diagnostic Radiology Medical Group Inc Body Imaging Past Accepting new patients
Regents of the University of California Past Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients
San Diego Diagnostic Radiology Medical Group, Inc. Past Accepting new patients

Locations

751 Medical Center Ct
Chula Vista, CA 91911
Phone (619) 482-3639

765 Medical Center Ct
Chula Vista, CA 91911
Phone (619) 397-6577

765 Medical Center Ct
Ste 101
Chula Vista, CA 91911

1415 Ross Ave
El Centro, CA 92243
Phone (760) 339-4045

9300 Valley Childrens Pl
Madera, CA 93636
Phone (559) 353-5700

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5720

200 W Arbor Dr
Ste I505
San Diego, CA 92103

250 Prospect Pl
San Diego, CA 92118
Phone (619) 522-3600

3020 Childrens Way
San Diego, CA 92123
Phone (858) 966-5841

3020 Childrens Way
#5003
San Diego, CA 92123
Phone (858) 309-6300

3075 Health Center Dr
San Diego, CA 92123
Phone (858) 637-7888

330 Lewis St
Ste 202
San Diego, CA 92103

330 Lewis St
Ste 400
San Diego, CA 92103
Phone (619) 471-9260

4250 1st Ave
San Diego, CA 92103
Phone (415) 290-8175

6655 Alvarado Rd
San Diego, CA 92120
Phone (619) 229-3130

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

7910 Frost St
Ste 100
San Diego, CA 92123
Phone (858) 634-5900

8745 Aero Dr
Ste 200
San Diego, CA 92123

Interoperability endpoints

  • Direct secure messaging: pkruk79822@valleychildrens-prd.direct-ci.com
  • Direct secure messaging: pkruk81225@scrippshlth.medalliesdirect.net

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 5

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1366480634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY",
            "address_2": "MC5003",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-576-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-576-1700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8745 Aero Dr",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921231761",
            "country_code": "US",
            "telephone_number": "858-565-0950",
            "fax_number": "858-244-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRUK",
        "first_name": "PETER",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "CA",
            "license": "A96070",
            "primary": true
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "CA",
            "license": "A96070",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.