Philip Anthony N Kruseman, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

017979 Issued in NY

Practice address

259 1St St
Mineola, NY 11501-3957

Phone

(763) 412-2803

NPI assigned

Sep 24, 2014

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

Enrolled in NY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989

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.

• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment
• Partners in Critical Care, LLP

  • Physician Assistant
  • Islip, NY
  • NPI 1053486670
  Medicare reassignment
• Samaritan Medical Services, P.C.

  • Internal Medicine Physician
  • West Islip, NY
  • NPI 1124184544
  Medicare reassignment

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

{
    "created_epoch": "1411516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411603200000",
    "number": "1902208671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12861 NIGHTINGALE ST NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554487028",
            "telephone_number": "763-412-2803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 1ST ST",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013957",
            "telephone_number": "763-412-2803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSEMAN",
        "first_name": "PHILIP",
        "middle_name": "ANTHONY N",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-24",
        "last_updated": "2014-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leonard Roy Krilov, M.D.
• Meenakshi Krishna
• Amritha Krishnamoorthy
• Guhan Krishnan, MD
• Stephen David Kronwith, MD
• Yi Kuang, PHARMD
• Juraj Kubis, MD
• John Ross Kucharczyk, MD
• Sandra Rulon Kuefner, NP
• Gwenda Robin Kugler, M.D.

• Physician Assistant in Mineola, NY
• Providers in Mineola, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2014; 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.