Individual provider Active NPI

Maxwell Emerson Kruse, MD

  • Emergency Medicine Physician
  • JB Andrews, MD
National Provider Identifier
1417419037
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
D95791 Issued in MD
Practice address
1060 W Perimeter Rd
JB Andrews, MD 20762-6602
Phone
(240) 857-2333
NPI assigned
Apr 2, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OH
Emergency Medicine Physician 207P00000X D95791 MD Primary

Addresses

Primary practice location

1060 W Perimeter Rd
JB Andrews, MD 20762-6602

Mailing address

3525 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 395-8839

Other practice location 1

3525 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 395-8839

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20221109000151 DC Practitioner - Emergency Medicine 6608118419 Reassigns benefits to 5 organizations
I20231124000100 MD Practitioner - Emergency Medicine 6608118419 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.52 of 100Reported as group
Quality
91.6
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as group
Quality
80.29
Promoting interoperability
100
Improvement activities
40
Cost
75.48

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D95791MDMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alexandria Springfield Emergency Physicians PC Emergency Medicine CurrentSince Nov 1, 2022 Accepting new patients
Medstar Medical Group II LLC CurrentSince May 1, 2025 Accepting new patients
WHC Emerg Phys CurrentSince Oct 10, 2023 Accepting new patients
WHC Physician Group LLC CurrentSince Oct 10, 2023 Accepting new patients
Emergency Medicine Associates P.a., P.C. Emergency Medicine CurrentSince Oct 24, 2022 Accepting new patients
Medstar Medical Group II LLC CurrentSince May 1, 2025 Accepting new patients
Fair Oaks Emergency Physicians, PLLC CurrentSince Jul 1, 2025 Accepting new patients
Alexandria Springfield Emergency Physicians PC Emergency Medicine Current Accepting new patients
Medstar Medical Group II LLC CurrentSince May 1, 2025 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Oct 24, 2022 Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000

3001 S Hanover St
Brooklyn Park, MD 21225
Phone (410) 350-3200

7503 Surratts Rd
Clinton, MD 20735
Phone (301) 868-8000

1406 Crain Hwy S
Glen Burnie, MD 21061
Phone (410) 768-6440

11355 Pembrooke Sq
Ste 108
Waldorf, MD 20603
Phone (202) 877-6733

4320 Seminary Rd
Alexandria, VA 22304
Phone (703) 504-3000

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

3600 Joseph Siewick Dr
Fairfax, VA 22033
Phone (703) 391-3037

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1417419037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 SOUTHERN BLVD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291221",
            "telephone_number": "937-395-8839",
            "fax_number": "937-395-8387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 W PERIMETER RD",
            "city": "JB ANDREWS",
            "state": "MD",
            "postal_code": "207626602",
            "telephone_number": "240-857-2333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3525 Southern Blvd",
            "address_purpose": "LOCATION",
            "city": "Kettering",
            "state": "OH",
            "postal_code": "454291221",
            "country_code": "US",
            "telephone_number": "937-395-8839",
            "fax_number": "937-395-8387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRUSE",
        "first_name": "MAXWELL",
        "middle_name": "EMERSON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-02",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D95791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in JB Andrews, MD

Sources for this page

Verify at the official NPI Registry.