Active NPI
Jennifer Kruger, OD
- Optometrist
- Waipahu, HI
National Provider Identifier
1700352184
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 900
- Practice address
- 94-1480 Moaniani St
Waipahu, HI 96797-4632 - Phone
- (808) 432-3100
- NPI assigned
- Oct 23, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 34132 | CA | |
| Optometrist | 152W00000X | 900 | HI | Primary |
Addresses
Primary practice location
94-1480 Moaniani St
Waipahu, HI 96797-4632
Mailing address
94-1480 Moaniani St
Waipahu, HI 96797-4632
Phone (808) 432-3100
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggateways | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34132 | CA | MD | Optometrist |
| 900 | HI | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vision Care Center of Hawaii LLC | Optometrist | Current | Accepting new patients |
Locations
94-050 Farrington Hwy
Ste B1-1
Waipahu, HI 96797
Phone (808) 677-1544
94-050 Farrington Hwy
Ste B11
Waipahu, HI 96797
Phone (808) 677-1544
Organizations & group practices 1
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.
-
- Optometrist
- Waipahu, HI
- NPI 1790442812
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628812800000",
"number": "1700352184",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "94-1480 MOANIANI ST",
"city": "WAIPAHU",
"state": "HI",
"postal_code": "967974632",
"telephone_number": "808-432-3100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "94-1480 MOANIANI ST",
"city": "WAIPAHU",
"state": "HI",
"postal_code": "967974632",
"telephone_number": "808-432-3100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRUGER",
"first_name": "JENNIFER",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-23",
"last_updated": "2021-08-13",
"certification_date": "2021-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "34132",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "HI",
"license": "900",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggateways",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "94-1480 Moaniani St",
"city": "Waipahu",
"state": "HI",
"country_code": "US",
"postal_code": "967974632",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Waipahu, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.