Individual provider Active NPI

Michael J Kruger, O.D.

  • Optometrist
  • Ames, IA
National Provider Identifier
1851383111
Registry record updated Oct 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2296 Issued in IA
Practice address
201 10TH St
Ames, IA 50010-6211
Phone
(515) 232-3451
Fax
(515) 233-4886
NPI assigned
Aug 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2007

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2296 IA Primary
Corneal and Contact Management Optometrist 152WC0802X 2296 IA
Pediatric Optometrist 152WP0200X 2296 IA
Sports Vision Optometrist 152WS0006X 2296 IA
Vision Therapy Optometrist 152WV0400X 2296 IA

Addresses

Primary practice location

201 10TH St
Ames, IA 50010-6211

Mailing address

201 10TH St
Ames, IA 50010-6211
Phone (515) 232-3451

Other identifiers 1

IdentifierTypeStateIssuer
1450254MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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

Enrollment IDStateProvider typePAC IDDetails
I20040902000217 IA Practitioner - Optometry 2365417243 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
John E Kruger, O.D., P.C.Group PAC ID 8729079181, 2 clinicians
Central Iowa Eye Associates, P.C.Group PAC ID 1355316464, 2 clinicians

Practice addresses (Care Compare)

201 10TH St
Ames, IA 50010-6211
Phone (515) 232-3451

2600 Grand Ave
Suite 202
Des Moines, IA 50312-5300
Phone (515) 243-1667

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery32

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2296IAMDSports Vision Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
John E Kruger, O.D., P.C. Optometrist CurrentSince Jul 12, 2004 Accepting new patients

Locations

201 10th St
Ames, IA 50010
Phone (515) 232-3451

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193011200000",
    "number": "1851383111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 10TH ST",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500106211",
            "telephone_number": "515-232-3451",
            "fax_number": "515-233-4886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 10TH ST",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500106211",
            "telephone_number": "515-232-3451",
            "fax_number": "515-233-4886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUGER",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2007-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "2296",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "IA",
            "license": "2296",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "IA",
            "license": "2296",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "IA",
            "license": "2296",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "IA",
            "license": "2296",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1450254",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ames, IA

Sources for this page

Verify at the official NPI Registry.