Active NPI
Karen J. Kruger, MD
- Pediatrics Physician
- Richmond, CA
National Provider Identifier
1477638138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- G69978
- Practice address
- 901 Nevin Ave
Richmond, CA 94801-3143 - Phone
- (510) 307-1500
- NPI assigned
- Oct 25, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | G69978 | CA | Primary |
Addresses
Primary practice location
901 Nevin Ave
Richmond, CA 94801-3143
Mailing address
1800 Harrison St FL 7
Oakland, CA 94612-3466
Phone (510) 625-6262
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G699780 | Medicaid | CA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) | The Permanente Medical Group |
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G69978 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| La Clinica de la Raza Inc | Current | Accepting new patients | |
| La Clinica de la Raza Inc | Current | Accepting new patients | |
| La Clinica de la Raza Inc | Current | Accepting new patients | |
| California Pacific Medical Group, Inc. | Past | Accepting new patients | |
| La Clinica de la Raza, Inc. | Past | Accepting new patients | |
| La Clinica de la Raza, Inc. | Past | Accepting new patients |
Locations
220 Hospital Dr
Vallejo, CA 94589
Phone (707) 641-1900
Organizations & group practices 7
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.
-
- Federally Qualified Health Center (FQHC)
- Concord, CA
- NPI 1538181482
-
- Federally Qualified Health Center (FQHC)
- Oakland, CA
- NPI 1144336181
-
- Federally Qualified Health Center (FQHC)
- Oakland, CA
- NPI 1346262292
-
- Federally Qualified Health Center (FQHC)
- Vallejo, CA
- NPI 1992863096
-
- Multi-Specialty Clinic/Center
- Oakland, CA
- NPI 1275002453
-
- Federally Qualified Health Center (FQHC)
- Oakland, CA
- NPI 1427070374
-
- Federally Qualified Health Center (FQHC)
- Vallejo, CA
- NPI 1720243454
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640131200000",
"number": "1477638138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 HARRISON ST FL 7",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946123466",
"telephone_number": "510-625-6262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 NEVIN AVE",
"city": "RICHMOND",
"state": "CA",
"postal_code": "948013143",
"telephone_number": "510-307-1500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRUGER",
"first_name": "KAREN",
"middle_name": "J.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-25",
"last_updated": "2021-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "G69978",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G699780",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "The Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "275 W MacArthur Blvd",
"city": "Oakland",
"state": "CA",
"country_code": "US",
"postal_code": "946115641",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Richmond, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.