Mark E Kruck, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

44258-020 Issued in WI

Practice address

700 S Park St
St. Marys Hospital/Dean Medical Center
Madison, WI 53715-1849

Phone

(608) 258-6975

Fax

(608) 258-5222

NPI assigned

May 8, 2006

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

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WI

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

Anesthesiology

Education

Medical College of Wisconsin, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health St Mary'S Hospital - Madison Hospital, Madison, WI, CCN 520083
• SSM Health St Clare Hospital - Baraboo Hospital, Baraboo, WI, CCN 520057
• Stoughton Hospital Hospital, Stoughton, WI, CCN 521343

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Dean Health Systems, Inc

  • Allergy & Immunology Physician
  • Madison, WI
  • NPI 1053358846

  Anesthesiology

  Medicare reassignment Care Compare group NPD
• Dean Health Systems, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Portage, WI
  • NPI 1427085679
  NPD

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

• SSM Health Care of Wisconsin Inc

  • General Acute Care Hospital
  • Baraboo, WI
  • NPI 1386641207
  Care Compare affiliation
• SSM Health Care of Wisconsin, Inc.

  • General Acute Care Hospital
  • Madison, WI
  • NPI 1184621211
  Care Compare affiliation
• Stoughton Hospital Association

  • Urgent Care Clinic/Center
  • McFarland, WI
  • NPI 1477146082

  Hospital

  Care Compare affiliation
• Stoughton Hospital Association

  • Critical Access Hospital
  • Stoughton, WI
  • NPI 1679558647
  Care Compare affiliation
• Stoughton Hospital Association

  • Urgent Care Clinic/Center
  • Cottage Grove, WI
  • NPI 1811733066

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1386693497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S PARK ST",
            "address_2": "ST. MARYS HOSPITAL/DEAN MEDICAL CENTER",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151849",
            "telephone_number": "608-258-6975",
            "fax_number": "608-258-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S PARK ST",
            "address_2": "ST. MARYS HOSPITAL/DEAN MEDICAL CENTER",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151849",
            "telephone_number": "608-258-6975",
            "fax_number": "608-258-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUCK",
        "first_name": "MARK",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "44258-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1386693497",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkruck259065@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mkruck259065@direct-ehr-ssmhc.com",
            "address_1": "700 S Park St",
            "address_2": "St. Marys Hospital/Dean Medical Center",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151849",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "700 S Park St",
            "address_2": "St. Marys Hospital/Dean Medical Center",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lisa Ellen Kromanaker, R.N.
• Jessica Lynn Kron
• Holly E Krook, ND
• Arnold J Krubsack, MD
• Emily Kruchten
• Michele A Kruckman, RN, CLC
• Adam Krueger, ATC,LAT,CSCS
• Christine Krueger, MASL, OTR
• Erika E Krueger, RN
• Katherine Krueger

• Anesthesiology Physician in Madison, WI
• Providers in Madison, WI by specialty
• Anesthesiology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2020; 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.