Individual provider Active NPI

Bernardo D Kruszel, M.D.

  • Internal Medicine Physician
  • Stuart, FL
National Provider Identifier
1912993114
Registry record updated Jun 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME64940 Issued in FL
Practice address
1607 NW Federal Hwy
#B
Stuart, FL 34994-9600
Phone
(772) 692-8082
Fax
(772) 232-9211
NPI assigned
Sep 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME64940 FL Primary

Addresses

Primary practice location

1607 NW Federal Hwy
#B
Stuart, FL 34994-9600

Mailing address

16146 Poppyseed Cir
#1102
Delray Beach, FL 33484-6329
Phone (561) 819-0497

Other identifiers 1

IdentifierTypeStateIssuer
375092200MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040329000421 FL Practitioner - Emergency MedicinePractitioner - Internal Medicine 8527950054 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Small Hospital Innovations LLCGroup PAC ID 0840415444, 95 clinicians

Practice addresses (Care Compare)

524 W Sagamore Ave
Clewiston, FL 33440-3514
Phone (863) 983-9121

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Shi Keys LLC CurrentSince Dec 15, 2020 Accepting new patients
Small Hospital Innovations LLC CurrentSince Jun 1, 2014 Accepting new patients
Big Water Emergency Physicians, LLC PastSince Aug 18, 2019 Accepting new patients
Speckled Perch Emergency Physicians Past Accepting new patients
Okeechobee Emergency Physicians Inc Past Accepting new patients

Locations

524 W Sagamore Ave
Clewiston, FL 33440
Phone (800) 494-3984

3301 Overseas Hwy
Marathon, FL 33050
Phone (305) 743-5533

91500 Overseas Hwy
Tavernier, FL 33070
Phone (305) 434-3000

Organizations & group practices 5

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309392000000",
    "number": "1912993114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16146 POPPYSEED CIR",
            "address_2": "#1102",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334846329",
            "telephone_number": "561-819-0497",
            "fax_number": "561-819-0498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 NW FEDERAL HWY",
            "address_2": "#B",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349949600",
            "telephone_number": "772-692-8082",
            "fax_number": "772-232-9211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSZEL",
        "first_name": "BERNARDO",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2011-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME64940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "375092200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

Verify at the official NPI Registry.