Kendra Kruger

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

9245 Quantrelle Ave NE
Otsego, MN 55330-0168

Phone

(763) 746-9492

NPI assigned

Oct 1, 2016

Sex

Female

Sole proprietor

No

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 MN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Nystrom & Associates, LTD

  dba Sagent Behavioral Health

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  Medicare reassignment
• Family Support Services Inc.

  dba Sagent Behavioral Health

  • Mental Health Counselor
  • New Brighton, MN
  • NPI 1467549220
  NPD (past)

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

{
    "created_epoch": "1475280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512172800000",
    "number": "1568911543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9245 QUANTRELLE AVE NE",
            "city": "OTSEGO",
            "state": "MN",
            "postal_code": "553300168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9245 QUANTRELLE AVE NE",
            "city": "OTSEGO",
            "state": "MN",
            "postal_code": "553300168",
            "telephone_number": "763-746-9492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUGER",
        "first_name": "KENDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-01",
        "last_updated": "2017-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Klutch, MA, LPCC
• Ann M Kooiker, MD
• Angela M Krats, MSW, LGSW
• Rachel Krautbauer, DPT
• Jennifer Krebs
• Belinda M Kubri
• Emily Kyle, OD
• Shirlee Corrine Lansing, LICSW
• Jolene Marie Carlson Law, M.S., CF-SLP
• Caitlin Lawrence

• Physician Assistant in Otsego, MN
• Providers in Otsego, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.