Kelly M Krueger, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101011317 Issued in MI

Practice address

39555 W. Ten Mile
#302
Novi, MI 48375

Phone

(248) 426-7200

Fax

(247) 426-7335

NPI assigned

Jan 4, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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 1

Specialty

Family Practice

Education

Michigan State University College of Osteopathic Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Providence Hospital, Southfield and Novi Hospital, Southfield, MI, CCN 230019

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kelly.krueger.1@27910.direct.athenahealth.com
• Direct secure messaging: kkrueger281727@direct.hfhs.org

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.

• Kelly M Krueger DO PLLC

  • Family Medicine Physician
  • Novi, MI
  • NPI 1144551805
  Medicare reassignment Authorized official
• American Indian Health and Family Services of Southeastern Mi Inc

  • Federally Qualified Health Center (FQHC)
  • Detroit, MI
  • NPI 1366552804

  Family Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Henry Ford Health Providence Hospital

  • General Acute Care Hospital
  • Novi, MI
  • NPI 1144210253
  Care Compare affiliation

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229472000000",
    "number": "1487632014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39555 W. TEN MILE",
            "address_2": "#302",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "48375",
            "telephone_number": "248-426-7200",
            "fax_number": "247-426-7335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39555 W. TEN MILE",
            "address_2": "#302",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "48375",
            "telephone_number": "248-426-7200",
            "fax_number": "247-426-7335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "KELLY",
        "middle_name": "M",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-04",
        "last_updated": "2008-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101011317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Krohn
• Josiah Kroontje
• Ada Krueger
• Blair Elyse Krueger
• Kaitlyn Nicole Krueger
• Staci Lynn Kruger
• Tammy Kruger, CNP
• Edyta Sylwia Krukowska-Urban, PHD, LP
• Malia Krupin
• Julie Kruse

• Family Medicine Physician in Novi, MI
• Providers in Novi, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.

Verify at the official NPI Registry.