NPIMap

Individual provider Active NPI

Adam D Kruse, DO

  • Family Medicine Physician
  • Waukee, IA
National Provider Identifier
1467525030
Registry record updated Jan 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO-04336 Issued in IA
Practice address
25 W Hickman Rd
Waukee, IA 50263-5020
Phone
(515) 643-7000
Fax
(515) 643-7001
NPI assigned
Nov 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0102202404 VA
Family Medicine Physician 207Q00000X 4336 IA
Family Medicine Physician 207Q00000X DO-04336 IA Primary

Addresses

Primary practice location

25 W Hickman Rd
Waukee, IA 50263-5020

Mailing address

PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 643-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, OH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130316000049 IA Practitioner - Family Practice 7315182516 Reassigns benefits to 1 organization
I20241203004494 OH Practitioner - Emergency Medicine 7315182516 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Iowa, RJ & L Carver College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinics IncGroup PAC ID 7911810882, 441 clinicians

Practice addresses (Care Compare)

1601 NW 114TH St
Suite 245
Clive, IA 50325-7036
Phone (515) 222-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO-04336IAMDFamily Medicine Physician
0102202404VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinics, Inc. Family Medicine Current Accepting new patients
Miami Valley Emergency Specialists, LLC CurrentSince Dec 1, 2024 Accepting new patients
Mercy Clinics, Inc. Past Accepting new patients

Locations

1601 NW 114th St
Ste 245
Des Moines, IA 50325
Phone (515) 222-7000

1 Wyoming St
Dayton, OH 45409
Phone (937) 208-2636

1 Medical Center Dr
Middletown, OH 45005
Phone (513) 424-2111

Interoperability endpoints

  • Direct secure messaging: akruse3950043@direct.trinity-health.org

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.

Hospital & facility affiliations 5

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421971200000",
    "number": "1467525030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1475",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503051475",
            "telephone_number": "515-643-7000",
            "fax_number": "515-643-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 W HICKMAN RD",
            "city": "WAUKEE",
            "state": "IA",
            "postal_code": "502635020",
            "telephone_number": "515-643-7000",
            "fax_number": "515-643-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSE",
        "first_name": "ADAM",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2015-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102202404",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "4336",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "DO-04336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukee, IA

Sources for this page

Verify at the official NPI Registry.