Individual provider Active NPI

John A Kruba, DO

  • Family Medicine Physician
  • Palm Springs, CA
National Provider Identifier
1922092923
Registry record updated Feb 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A6776 Issued in CA
Practice address
275 N El Cielo Rd
Palm Springs, CA 92262-6972
Phone
(760) 320-8814
Fax
(760) 323-7204
NPI assigned
Sep 6, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A6776 CA Primary

Addresses

Primary practice location

275 N El Cielo Rd
Palm Springs, CA 92262-6972

Mailing address

275 N El Cielo
Palm Springs, CA 92262
Phone (760) 323-8657

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20090926000013 CA Practitioner - Family Practice 7911053376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
R Franklin University of Med & Sci/Chicago Medical School, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Desert Medical Group IncGroup PAC ID 8123930427, 71 clinicians

Practice addresses (Care Compare)

275 N El Cielo Rd
Palm Springs, CA 92262-6972
Phone (760) 323-8657

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A6776CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Medical Group, Inc. Family Medicine CurrentSince Apr 15, 2003 Accepting new patients

Locations

265 N El Cielo Rd
Ste B104
Palm Springs, CA 92262

275 N El Cielo Rd
Palm Springs, CA 92262
Phone (760) 320-8814

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: john.kruba.p2@direct.mydohc.nextgenshare.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328054400000",
    "number": "1922092923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 N EL CIELO",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "92262",
            "telephone_number": "760-323-8657",
            "fax_number": "760-318-9083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 N EL CIELO RD",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922626972",
            "telephone_number": "760-320-8814",
            "fax_number": "760-323-7204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUBA",
        "first_name": "JOHN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-06",
        "last_updated": "2012-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A6776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, CA

Sources for this page

Verify at the official NPI Registry.