Individual provider Active NPI

Kenneth J Krueger, DPM

  • Podiatrist
  • Westfield, IN
National Provider Identifier
1538159231
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
07000391A Issued in IN
Practice address
15022 Sullivan LN
Westfield, IN 46074-9802
Phone
(317) 713-1111
Fax
(317) 713-1100
NPI assigned
Oct 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 07000391A IN Primary

Addresses

Primary practice location

15022 Sullivan LN
Westfield, IN 46074-9802

Mailing address

15022 Sullivan LN
Westfield, IN 46074-9802
Phone (317) 713-1111

Other identifiers 2

IdentifierTypeStateIssuer
000000344455OtherINANTHEM BLUE CROSS AND BLUE SHIELD
100060080MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040825000960 IN Practitioner - Podiatry 8527032499 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15022 Sullivan LN
Westfield, IN 46074-9802
Phone (317) 713-1111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue106
Removal of nail tissue3145
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
07000391AINMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Care Podiatry Podiatrist CurrentSince Mar 1, 2004 Accepting new patients
Meridian Health Group Podiatrist Past Accepting new patients

Locations

4725 Statesmen Dr
Ste A
Indianapolis, IN 46250
Phone (317) 713-1111

Interoperability endpoints

  • Direct secure messaging: kkrueger62003@ecommunitydirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1538159231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15022 SULLIVAN LN",
            "city": "WESTFIELD",
            "state": "IN",
            "postal_code": "460749802",
            "telephone_number": "317-713-1111",
            "fax_number": "317-713-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15022 SULLIVAN LN",
            "city": "WESTFIELD",
            "state": "IN",
            "postal_code": "460749802",
            "telephone_number": "317-713-1111",
            "fax_number": "317-713-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "KENNETH",
        "middle_name": "J",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IN",
            "license": "07000391A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS AND BLUE SHIELD",
            "identifier": "000000344455",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100060080",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westfield, IN

Sources for this page

Verify at the official NPI Registry.