Roger John Kruse, M.D.

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

35043625 Issued in OH

Practice address

2865 N Reynolds Rd
Ste 130
Toledo, OH 43615-2068

Phone

(419) 578-7036

Fax

(419) 537-5597

NPI assigned

Jun 24, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

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

University of Cincinnati College of Medicine, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068
• Mercy St Vincent Medical Center Hospital, Toledo, OH, CCN 360112

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rkruse26608@direct.promedica.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.

• Promedica Central Physicians

  • Family Medicine Physician
  • Toledo, OH
  • NPI 1043270150
  Medicare reassignment Care Compare group NPD
• The Toledo Hospital

  • General Acute Care Hospital
  • Toledo, OH
  • NPI 1407854771
  Medicare reassignment NPD
• Promedica Central Physicians

  • Durable Medical Equipment & Medical Supplies
  • Toledo, OH
  • NPI 1669068482
  NPD
• The Toledo Hospital

  • Community/Retail Pharmacy
  • Toledo, OH
  • NPI 1740217678
  NPD
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

• Mercy Health - St Vincent Medical Center LLC

  • General Acute Care Hospital
  • Toledo, OH
  • NPI 1467493551
  Care Compare affiliation
• The Toledo Hospital

  • General Acute Care Hospital
  • Toledo, OH
  • NPI 1407854771
  Care Compare affiliation
• Toledo Hospital

  • Ambulance
  • Toledo, OH
  • NPI 1427147339

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1487650339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2865 N REYNOLDS RD",
            "address_2": "STE 130",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436152068",
            "telephone_number": "419-578-7036",
            "fax_number": "419-537-5597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2865 N REYNOLDS RD",
            "address_2": "STE 130",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436152068",
            "telephone_number": "419-578-7036",
            "fax_number": "419-537-5597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSE",
        "first_name": "ROGER",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "OH",
            "license": "35043625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2048386",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "KR0473103",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "080190310",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rkruse26608@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• William S Krost, MD, MBA, NRP
• Charity Krouse, QMHS
• Amanda Krueger, LPN
• Amanda R Kruse, CNP
• Cassandra Kruse, PHARMD, RPH
• John Anthony Kruszewski, O.D.
• Mary Martha Frances Krutsch
• Brittany Nicole Krzeminski
• Jessy Krzeminski
• KS Counseling LLC

• Sports Medicine (Family Medicine) Physician in Toledo, OH
• Providers in Toledo, OH by specialty
• Sports Medicine (Family Medicine) Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; 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.