Daryl L Kruse, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2442035 Issued in WI

Practice address

5802 Washington Ave
Mount Pleasant, WI 53406-4050

Phone

(414) 955-2020

Fax

(414) 955-6300

NPI assigned

Oct 28, 2005

Last updated

Sep 25, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Medical College of Wisconsin IncGroup PAC ID 2668384371, 2,092 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

87.99 of 100Reported as group

Quality

82.81

Promoting interoperability

100

Improvement activities

40

Cost

77.15

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dkruse331769@direct.froedtert.com

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.

• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086

  Optometrist

  Medicare reassignment Care Compare group NPD
• Optical Dept. of Eye Clinic of Racine, LTD.

  • Eyewear Supplier
  • Racine, WI
  • NPI 1629049150
  NPD (past)
• The Medical College of Wisconsin Inc

  • Case Management Agency
  • Milwaukee, WI
  • NPI 1649521105
  NPD (past)

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569369600000",
    "number": "1659361772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5802 WASHINGTON AVE",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534064050",
            "telephone_number": "414-955-2020",
            "fax_number": "414-955-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5802 WASHINGTON AVE",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534064050",
            "telephone_number": "414-955-2020",
            "fax_number": "414-955-6300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3805A Spring St",
            "address_2": "Suite 111",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "WI",
            "postal_code": "534051600",
            "country_code": "US",
            "telephone_number": "262-637-9615",
            "fax_number": "262-637-4437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRUSE",
        "first_name": "DARYL",
        "middle_name": "L",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-28",
        "last_updated": "2019-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2442035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38583600",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659361772",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachael Kozinski
• Madeline Kreis, SLP
• Alicia Krell
• Jeffrey Thomas Vaughan Kroeger, CRNA
• Claire Kromm, DPT
• Mickey Kucak, LCSW
• Kathryn Ann Kulba, D.C.
• Pradeep Gopi Kumar, MD
• Jadelyn Kurtz, MS, SLP
• Ye Eun Kwak, M.D.

• Optometrist in Mount Pleasant, WI
• Providers in Mount Pleasant, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2019; 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.