Individual provider Active NPI

Fabiane Hirsch Kruse, PH.D.

  • Speech-Language Pathologist
  • Tucson, AZ
National Provider Identifier
1528327343
Registry record updated Mar 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP#1636 Issued in AZ
Practice address
1011 N Craycroft Rd
Suite 301
Tucson, AZ 85711-7309
Phone
(520) 730-8428
Fax
(520) 300-8328
NPI assigned
May 14, 2012
Last updated
Mar 14, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP#1636 AZ Primary

Addresses

Primary practice location

1011 N Craycroft Rd
Suite 301
Tucson, AZ 85711-7309

Mailing address

1011 N Craycroft Rd
Suite 301
Tucson, AZ 85711-7309
Phone (520) 730-8428

Other identifiers 1

IdentifierTypeStateIssuer
713722MedicaidAZ

Other names 1

  • Fabiane Hirsch Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
SLP#1636AZMDSpeech-Language Pathologist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1336953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363219200000",
    "number": "1528327343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 N CRAYCROFT RD",
            "address_2": "SUITE 301",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857117309",
            "telephone_number": "520-730-8428",
            "fax_number": "520-300-8328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 N CRAYCROFT RD",
            "address_2": "SUITE 301",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857117309",
            "telephone_number": "520-730-8428",
            "fax_number": "520-300-8328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIRSCH KRUSE",
        "first_name": "FABIANE",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-14",
        "last_updated": "2013-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP#1636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "713722",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FABIANE",
            "last_name": "HIRSCH",
            "credential": "PH.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.