NPIMap

Organization Active NPI

Christopher B. Kruse, M.D., LLC

  • Dermatology Physician
  • Red Bank, NJ
National Provider Identifier
1457598112
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
CHRISTOPHER B. KRUSE, M.D., LLC
Practice address
225 State Route 35 Ste 208
Red Bank, NJ 07701-5919
Phone
(732) 747-5500
Fax
(732) 747-1212
NPI assigned
Jan 15, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Authorized official

Name
Christopher Bryant KruseNPI 1083636898
Title
President
Phone
(973) 641-4511

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X Primary
MOHS-Micrographic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0101X

Addresses

Primary practice location

225 State Route 35 Ste 208
Red Bank, NJ 07701-5919

Mailing address

225 State Route 35 Ste 208
Red Bank, NJ 07701-5919
Phone (732) 747-5500

Other names 1

  • Dermatology and Skin Cancer Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090821000338 NJ Part B Supplier - Clinic/Group Practice 5890849020 Receives reassigned benefits from 19 practitioners
Practice locations: Red Bank, NJ

National Provider Directory

National Provider Directory

Locations

55 N Gilbert St
Ste 1201
Tinton Falls, NJ 07701
Phone (732) 747-5500

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1231977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723680000000",
    "number": "1457598112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 STATE ROUTE 35 STE 208",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077015919",
            "telephone_number": "732-747-5500",
            "fax_number": "732-747-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 STATE ROUTE 35 STE 208",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077015919",
            "telephone_number": "732-747-5500",
            "fax_number": "732-747-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTOPHER B. KRUSE, M.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-15",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A",
        "authorized_official_last_name": "KRUSE",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "BRYANT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-641-4511"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dermatology and Skin Cancer Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Red Bank, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.