Active NPI
Peter G Kruk, M.D.
- Diagnostic Radiology Physician
- San Diego, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 225096
- Practice address
- 8745 Aero Dr
Suite 200
San Diego, CA 92123-1761 - Phone
- (858) 565-0950
- Fax
- (858) 244-1100
- NPI assigned
- Jun 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Body Imaging Physician | 2085B0100X | A96070 | CA | |
| Diagnostic Ultrasound Physician | 2085U0001X | A96070 | CA | |
| Neuroradiology Physician | 2085N0700X | A96070 | CA | |
| Nuclear Radiology Physician | 2085N0904X | A96070 | CA | |
| Diagnostic Radiology Physician | 2085R0202X | 225096 | MA | Primary |
| Pediatric Radiology Physician | 2085P0229X | A96070 | CA |
Addresses
Primary practice location
8745 Aero Dr
Suite 200
San Diego, CA 92123-1761
Mailing address
PO Box 23540
San Diego, CA 92193-3540
Phone (858) 565-0950
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0083812 | Medicaid | CA | |
| ZZZ75341Z | Medicaid | CA | |
| GR0083811 | Medicaid | CA | |
| GR0083817 | Medicaid | CA | |
| GR0083813 | Medicaid | CA | |
| GR0083815 | Medicaid | CA | |
| GR0083816 | Medicaid | CA | |
| GR0083810 | Medicaid | CA | |
| GR0083814 | Medicaid | CA |
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
Enrollment records 1
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
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
- Sharp Memorial Hospital
- Rady Children'S Hospital - San Diego
- Sharp Coronado Hospital and Hlthcr Ctr
- Sharp Chula Vista Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 98.75 of 100
- Quality
- 100
- Improvement activities
- 40
- Cost
- 72.17
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.08 of 100
- Quality
- 82.75
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A96070 | CA | MD | Nuclear Radiology Physician |
| 225096 | MA | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Diego Imaging, LLC | Current | Accepting new patients | |
| San Diego Diagnostic Radiology Medical Group, Inc. | Current | Accepting new patients | |
| San Diego Diagnostic Radiology Medical Group, Inc. | Body Imaging | Current | Accepting new patients |
| San Diego Imaging-Chula Vista LLC | Current | Accepting new patients | |
| Scripps Health | Current | Accepting new patients | |
| Regents of the University of California | Body Imaging | Current | Accepting new patients |
| San Diego Diagnostic Radiology Medical Group Inc | Body Imaging | Current | Accepting new patients |
| Wishon Radiological Medical Group, Inc. | Pediatric Radiology | Current | Accepting new patients |
| San Diego Diagnostic Radiology Medical Group Inc | Body Imaging | Past | Accepting new patients |
| San Diego Diagnostic Radiology Medical Group, Inc. | Past | Accepting new patients | |
| Regents of the University of California Ucsd Head and Neck Surgery | Past | Accepting new patients | |
| Regents of the University of California | Past | Accepting new patients |
Locations
765 Medical Center Ct
Chula Vista, CA 91911
Phone (619) 397-6577
751 Medical Center Ct
Chula Vista, CA 91911
Phone (619) 482-3639
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
7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400
330 Lewis St
Ste 202
San Diego, CA 92103
4250 1st Ave
San Diego, CA 92103
Phone (415) 290-8175
8745 Aero Dr
Ste 200
San Diego, CA 92123
330 Lewis St
Ste 400
San Diego, CA 92103
Phone (619) 471-9250
200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754
3020 Childrens Way
San Diego, CA 92123
Phone (858) 966-5841
7910 Frost St
Ste 100
San Diego, CA 92123
Phone (858) 634-5900
200 W Arbor Dr
Ste I505
San Diego, CA 92103
3075 Health Center Dr
San Diego, CA 92123
Phone (858) 637-7888
6655 Alvarado Rd
San Diego, CA 92120
Phone (619) 229-3130
250 Prospect Pl
San Diego, CA 92118
Phone (619) 522-3600
Interoperability endpoints
- pkruk79822@valleychildrens-prd.direct-ci.com
- 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 and National Provider Directory roles.
-
- Diagnostic Radiology Physician
- Coronado, CA
- NPI 1417988221
Body Imaging
-
- Radiology Clinic/Center
- Chula Vista, CA
- NPI 1649207812
-
- Diagnostic Radiology Physician
- Fresno, CA
- NPI 1528012168
Pediatric Radiology
-
- Diagnostic Radiology Physician
- San Diego, CA
- NPI 1558463927
Body Imaging
-
- Clinic/Center
- San Diego, CA
- NPI 1780312371
-
- Radiology Clinic/Center
- San Diego, CA
- NPI 1043378136
-
- Diagnostic Radiology Physician
- San Diego, CA
- NPI 1629156583
Body Imaging
-
- General Acute Care Hospital
- San Diego, CA
- NPI 1487928891
-
- Pharmacy
- San Diego, CA
- NPI 1598786576
-
- Otolaryngology Physician
- San Diego, CA
- NPI 1679509962
-
- Diagnostic Radiology Physician
- San Diego, CA
- NPI 1326075375
Body Imaging
-
- Magnetic Resonance Imaging (MRI) Clinic/Center
- San Diego, CA
- NPI 1861788093
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Children's Hospital
- San Diego, CA
- NPI 1710065933
-
- General Acute Care Hospital
- Chula Vista, CA
- NPI 1396728630
-
- General Acute Care Hospital
- Coronado, CA
- NPI 1154304475
-
- Rehabilitation Hospital Unit
- San Diego, CA
- NPI 1114901352
-
- General Acute Care Hospital
- San Diego, CA
- NPI 1407839921
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": "1191888000000",
"number": "1366480634",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 23540",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921933540",
"telephone_number": "858-565-0950",
"fax_number": "858-565-2863"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8745 AERO DR",
"address_2": "SUITE 200",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921231761",
"telephone_number": "858-565-0950",
"fax_number": "858-244-1100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRUK",
"first_name": "PETER",
"middle_name": "G",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-02",
"last_updated": "2007-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "2085B0100X",
"taxonomy_group": "",
"desc": "Radiology, Body Imaging",
"state": "CA",
"license": "A96070",
"primary": false
},
{
"code": "2085U0001X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Ultrasound",
"state": "CA",
"license": "A96070",
"primary": false
},
{
"code": "2085N0700X",
"taxonomy_group": "",
"desc": "Radiology, Neuroradiology",
"state": "CA",
"license": "A96070",
"primary": false
},
{
"code": "2085N0904X",
"taxonomy_group": "",
"desc": "Radiology, Nuclear Radiology",
"state": "CA",
"license": "A96070",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MA",
"license": "225096",
"primary": true
},
{
"code": "2085P0229X",
"taxonomy_group": "",
"desc": "Radiology, Pediatric Radiology",
"state": "CA",
"license": "A96070",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0083812",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ZZZ75341Z",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0083811",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0083817",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0083813",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0083815",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0083816",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0083810",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0083814",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; 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.