Shane H Kruitbosch, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

10083 Issued in NV

Practice address

4165 Twin Falls Dr
Reno, NV 89511

Phone

(775) 348-1313

Fax

(775) 348-1798

NPI assigned

Jun 3, 2006

Last updated

Feb 5, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NV, CA, AZ3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Specialty

Anesthesiology

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Yuma Regional Medical CenterGroup PAC ID 2062314826, 367 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Yuma Regional Medical Center Hospital, Yuma, AZ, CCN 030013

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Yuma Regional Medical Center

  dba Onvida Health Yuma Medical Center

  • General Acute Care Hospital
  • Yuma, AZ
  • NPI 1194706655
  Medicare reassignment Care Compare group NPD
• Metcalf, Tiller & Chen, Inc.

  dba Reno Tahoe Anesthesia

  • Anesthesiology Physician
  • Reno, NV
  • NPI 1811237431
  Medicare reassignment NPD
• Reno Tahoe Anesthesia Weaver PC

  dba Reno Tahoe Anesthesia PC

  • Anesthesiology Physician
  • Reno, NV
  • NPI 1548816895
  Medicare reassignment NPD
• Cep America - Anesthesia, PC

  • Anesthesiology Physician
  • Walnut Creek, CA
  • NPI 1790401438
  Medicare reassignment NPD
• Oak Creek Anesthesia Services, Inc.

  • Anesthesiology Physician
  • Visalia, CA
  • NPI 1619589512
  Medicare reassignment NPD
• Cep America - Anesthesia PC

  • Anesthesiology Physician
  • Redding, CA
  • NPI 1013561851
  NPD
• Cep America - Anesthesia PC

  • Anesthesiology Physician
  • Langhorne, PA
  • NPI 1093678229
  NPD
• Picetti LTD

  dba Sierra Anesthesia, Inc

  • Anesthesiology Physician
  • Reno, NV
  • NPI 1316989742
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Yuma Regional Medical Center

  dba Onvida Health Yuma Medical Center

  • General Acute Care Hospital
  • Yuma, AZ
  • NPI 1194706655
  Care Compare affiliation

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644019200000",
    "number": "1649218611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18124 WEDGE PKWY # 933",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895118134",
            "telephone_number": "775-742-0734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4165 TWIN FALLS DR",
            "city": "RENO",
            "state": "NV",
            "postal_code": "89511",
            "telephone_number": "775-348-1313",
            "fax_number": "775-348-1798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUITBOSCH",
        "first_name": "SHANE",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2022-02-05",
        "certification_date": "2022-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "K9827",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "C134131",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OR",
            "license": "MD207244",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NV",
            "license": "10083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2016072",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jauquetta Kron
• Holly Marie Kroon, APN
• Judy D Kroshus, MAED
• Christi Krueger
• Jessica Anne Kruger
• Leah Kathryn Krull, M.D.
• Joanne Krumpe, PH.D
• Krystons Home Care
• Krystons Home Care II
• Marianna Kryvokrysenko, MD

• Anesthesiology Physician in Reno, NV
• Providers in Reno, NV by specialty
• Anesthesiology Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2022; 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.
• 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.