Caleb Kruse, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA61096550 Issued in WA

Practice address

1315 N Division St
Spokane, WA 99202-1899

Phone

(509) 487-4467

NPI assigned

Jul 11, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1594425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1861010241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 N DIVISION ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021899",
            "telephone_number": "509-487-4467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 N DIVISION ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021899",
            "telephone_number": "509-487-4467"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "702 S Park St",
            "address_purpose": "LOCATION",
            "city": "Deer Park",
            "state": "WA",
            "postal_code": "990067025",
            "country_code": "US",
            "telephone_number": "509-262-9000",
            "fax_number": "509-276-3034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRUSE",
        "first_name": "CALEB",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-11",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61096550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda L Kruger, CDP
• Kim Krull, LAC.
• Natalie Sue Krumbah, LMP
• Nicole Krupke, MPT
• Duane August Kruschke II
• Samantha Kruse, RN
• Madeleine Wade Krutz
• Jenn Renee Reylo Krzmarzick, LMHC
• Bradley Kubat, MHC
• Kathryn M Kubik, PA-C

• Physician Assistant in Spokane, WA
• Providers in Spokane, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.