NPIMap

Individual provider Active NPI

Henry G Krull, M.D.

  • Orthopaedic Surgery Physician
  • Soldotna, AK
National Provider Identifier
1669477790
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
4336 Issued in AK
Practice address
289 N Fireweed St Ste D
Soldotna, AK 99669-7570
Phone
(907) 262-6454
Fax
(907) 262-0832
NPI assigned
Jun 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 4336 AK Primary

Addresses

Primary practice location

289 N Fireweed St Ste D
Soldotna, AK 99669-7570

Mailing address

291 N Fireweed St
Soldotna, AK 99669-7540
Phone (907) 262-6454

Other identifiers 2

IdentifierTypeStateIssuer
MD 4333MedicaidAK
200039684OtherAKALASKA RAILROAD I.D.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100331001190 AK Practitioner - Orthopedic Surgery 8820020639 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Northwestern University Feinberg Medical School, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Independence Healthcare PCGroup PAC ID 0648264549, 2 clinicians

Practice addresses (Care Compare)

130 S Willow St
Suite 1
Kenai, AK 99611-9107
Phone (907) 262-6454

289 N Fireweed St
Soldotna, AK 99669-7570

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

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

Merit-based Incentive Payment System (MIPS)

Final score
70.59 of 100Reported as group
Quality
83.37
Promoting interoperability
100
Improvement activities
40
Cost
16.65

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)15
Upper limb (arm) arthroscopy (minimally invasive joint repair)23
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1100AKMDPharmacist
4336AKMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kpo Rehabilitation and Sports Medicine Inc. Current Accepting new patients
Kpo Rehabilitation & Sports Medicine CurrentSince Feb 1, 2008 Accepting new patients
Independence Healthcare PC Orthopaedic Surgery CurrentSince Aug 23, 1999 Accepting new patients
Independence Healthcare PC CurrentSince Aug 23, 1999 Accepting new patients

Locations

130 S Willow St
Ste 1
Kenai, AK 99611
Phone (907) 262-2596

289 N Fireweed St
Ste D
Soldotna, AK 99669
Phone (907) 262-6454

291 N Fireweed St
Soldotna, AK 99669
Phone (907) 262-6454

Organizations & group practices 4

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.

Hospital & facility affiliations 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1669477790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 N FIREWEED ST",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697540",
            "telephone_number": "907-262-6454",
            "fax_number": "907-262-0834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 N FIREWEED ST STE D",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697570",
            "telephone_number": "907-262-6454",
            "fax_number": "907-262-0832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRULL",
        "first_name": "HENRY",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AK",
            "license": "4336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD 4333",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALASKA RAILROAD I.D.",
            "identifier": "200039684",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Soldotna, AK

Sources for this page

Verify at the official NPI Registry.