Individual provider Active NPI

Carolyn Backes Krouse, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1497345219
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
95031121 Issued in CA
Practice address
8635 W 3Rd St Ste 795W
Los Angeles, CA 90048-6129
Phone
(310) 423-5874
Fax
(310) 423-0139
NPI assigned
Jan 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 95031121 CA Primary
Acute Care Nurse Practitioner 363LA2100X 4704317212 MI

Addresses

Primary practice location

8635 W 3Rd St Ste 795W
Los Angeles, CA 90048-6129

Mailing address

4140 W 190TH St
Torrance, CA 90504-5513
Phone (310) 423-5874

Other practice location 1

6071 W Outer Dr
Detroit, MI 48235-2624
Phone (313) 966-3000

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250723002522 CA Practitioner - Nurse Practitioner 6608382841 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cedars-Sinai Medical CenterGroup PAC ID 0446169114, 788 clinicians

Practice addresses (Care Compare)

8636 W 3Rd St
Los Angeles, CA 90048-3323
Phone (310) 423-5000

Hospital & facility affiliations

  • Cedars-Sinai Medical Center Hospital, Los Angeles, CA, CCN 050625

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95031121CAMDAcute Care Nurse Practitioner
4704317212MIMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Center CurrentSince Jun 1, 2025 Accepting new patients
Cedars-Sinai Medical Center CurrentSince Jun 1, 2025 Accepting new patients

Locations

8635 W 3rd St
Ste 795W
Los Angeles, CA 90048
Phone (310) 423-8350

8636 W 3rd St
Los Angeles, CA 90048

4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780

8700 Beverly Blvd
West Hollywood, CA 90048
Phone (310) 385-3291

Interoperability endpoints

  • Direct secure messaging: ckrouse510102@direct.cshs.org

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1611532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1497345219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 W 190TH ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905045513",
            "telephone_number": "310-423-5874",
            "fax_number": "310-423-0139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8635 W 3RD ST STE 795W",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900486129",
            "telephone_number": "310-423-5874",
            "fax_number": "310-423-0139"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6071 W Outer Dr",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482352624",
            "country_code": "US",
            "telephone_number": "313-966-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KROUSE",
        "first_name": "CAROLYN",
        "middle_name": "BACKES",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-25",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95031121",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704317212",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.