Individual provider Active NPI

Nichole Lee Kruse, DPT

  • Physical Therapist
  • Goodyear, AZ
National Provider Identifier
1639476930
Registry record updated Mar 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9253 Issued in AZ
Practice address
14557 W Indian School Rd
Suite 500B
Goodyear, AZ 85395-9243
Phone
(623) 242-6908
Fax
(623) 242-6909
NPI assigned
Feb 22, 2011
Last updated
Mar 9, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 9253 AZ Primary

Addresses

Primary practice location

14557 W Indian School Rd
Suite 500B
Goodyear, AZ 85395-9243

Mailing address

14557 W Indian School Rd
Suite 500B
Goodyear, AZ 85395-9243
Phone (623) 242-6908

Medicare participation

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

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
58.17 of 100Reported as group
Quality
37.51
Improvement activities
40
Cost
75.14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9253AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Orthopedic Physical Therapy, PLLC PastSince Oct 1, 2014 Accepting new patients
Therapy West LLC Physical Therapist PastSince Feb 14, 2023 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1298332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425859200000",
    "number": "1639476930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14557 W INDIAN SCHOOL RD",
            "address_2": "SUITE 500B",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853959243",
            "telephone_number": "623-242-6908",
            "fax_number": "623-242-6909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14557 W INDIAN SCHOOL RD",
            "address_2": "SUITE 500B",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853959243",
            "telephone_number": "623-242-6908",
            "fax_number": "623-242-6909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSE",
        "first_name": "NICHOLE",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-22",
        "last_updated": "2015-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "9253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.