Active NPI
Michael Krutzik, MD
- Internal Medicine Physician
- Brawley, CA
National Provider Identifier
1447290168
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- A66632
- Practice address
- 528 G St
Brawley, CA 92227-2411 - Phone
- (760) 344-6355
- NPI assigned
- Jun 8, 2006
- Last updated
- Jan 18, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A66632 | CA | Primary |
Addresses
Primary practice location
528 G St
Brawley, CA 92227-2411
Mailing address
528 G St
Brawley, CA 92227-2411
Phone (760) 344-6355
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A666320 | Other | CA | BLUE SHIELD OF CA |
| 00A666320 | 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
- Pulmonary Disease
- Education
- Medical College of Wisconsin, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
790 W Orange Ave
Suite C
El Centro, CA 92243-3274
Phone (760) 352-6766
Hospital & facility affiliations
- El Centro Regional Medical Center
- Pioneers Memorial Healthcare District
- UC San Diego Health Hillcrest - Hillcrest Med Ctr
- Desert Regional Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 100
- Improvement activities
- 40
- Cost
- 73.03
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A66632 | CA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michael N Krutzik MD a Medical Corporation | Current | Accepting new patients | |
| Newport Critical Care Physicians Medical Group Inc | Internal Medicine | Past | Accepting new patients |
| James Jack Kohan MD LLC | Past | Accepting new patients |
Locations
528 G St
Brawley, CA 92227
Phone (760) 344-1881
790 W Orange Ave
Ste C
El Centro, CA 92243
Phone (760) 352-6766
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/GHFDDD
- https://fhir4.healow.com/fhir/r4/GHFDDD/Endpoint/GHFDDD
Organizations & group practices 3
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.
-
- Pulmonary Disease Physician
- El Centro, CA
- NPI 1528253572
-
- Pulmonary Disease Physician
- Del Mar, CA
- NPI 1952633323
-
- Critical Care Medicine (Internal Medicine) Physician
- Newport Beach, CA
- NPI 1740220482
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Desert Regional Medical Center
- General Acute Care Hospital
- Palm Springs, CA
- NPI 1104856095
-
- General Acute Care Hospital
- El Centro, CA
- NPI 1861409823
-
dba Pioneers Memorial Hospital
- General Acute Care Hospital
- Brawley, CA
- NPI 1184429185
-
dba UCSD Medical Center
- General Acute Care Hospital
- San Diego, CA
- NPI 1184722779
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200614400000",
"number": "1447290168",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "528 G ST",
"city": "BRAWLEY",
"state": "CA",
"postal_code": "922272411",
"telephone_number": "760-344-6355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "528 G ST",
"city": "BRAWLEY",
"state": "CA",
"postal_code": "922272411",
"telephone_number": "760-344-6355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRUTZIK",
"first_name": "MICHAEL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-08",
"last_updated": "2008-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A66632",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD OF CA",
"identifier": "00A666320",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A666320",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brawley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2008; 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.