NPIMap

Individual provider Active NPI

Connor Matthew Krouse, PA

  • Physician Assistant
  • Lima, OH
National Provider Identifier
1407649940
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.010100RX Issued in OH
Practice address
801 Medical Dr Ste a
Lima, OH 45804-4030
Phone
(419) 222-6622
Fax
(419) 224-0015
NPI assigned
May 27, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.010100RX OH Primary

Addresses

Primary practice location

801 Medical Dr Ste a
Lima, OH 45804-4030

Mailing address

801 Medical Dr Ste a
Lima, OH 45804-4030
Phone (419) 222-6622

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260225003154 OH Practitioner - Physician Assistant 6406337682 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

801 Medical Dr
Suite a
Lima, OH 45804-4030
Phone (419) 222-6622

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.010100RXOHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Institute of Ohio, Inc CurrentSince Feb 2, 2026 Accepting new patients
Orthopaedic Institute of Ohio, Inc. CurrentSince Feb 2, 2026 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

801 Medical Dr
Ste A
Lima, OH 45804
Phone 41922266223301

801 Medical Dr
Lima, OH 45804
Phone (419) 227-0205

Organizations & group practices 4

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 4

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": "1748304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1407649940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 MEDICAL DR STE A",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458044030",
            "telephone_number": "419-222-6622",
            "fax_number": "419-224-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 MEDICAL DR STE A",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458044030",
            "telephone_number": "419-222-6622",
            "fax_number": "419-224-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROUSE",
        "first_name": "CONNOR",
        "middle_name": "MATTHEW",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-27",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.010100RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

Verify at the official NPI Registry.