Active NPI
David Allen Kruse, M.D.
- Pediatrics Physician
- Saint Cloud, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 54831
- Practice address
- 1900 Centracare Cir
Saint Cloud, MN 56303-5000 - Phone
- (320) 654-3610
- NPI assigned
- Jun 13, 2009
- Last updated
- Aug 9, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | R-8721 | IA | |
| Pediatrics Physician | 208000000X | 54831 | MN | Primary |
Addresses
Primary practice location
1900 Centracare Cir
Saint Cloud, MN 56303-5000
Mailing address
924 Celebration Cir
Sartell, MN 56377
Phone (319) 621-3732
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1900 Centracare Cir
Suite 1340
Saint Cloud, MN 56303-5000
Phone (320) 229-5105
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R-8721 | IA | MD | Pediatrics Physician |
| 54831 | MN | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centracare Clinic | Current | Accepting new patients | |
| Centracare Clinic | Current | Accepting new patients | |
| Centracare Clinic | Current | Accepting new patients |
Locations
1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342
1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422
1900 Centracare Cir
Ste 1300
Saint Cloud, MN 56303
Phone (320) 654-3610
1900 Centracare Cir
Ste 1340
Sartell, MN 56303
Phone (320) 229-5105
Interoperability endpoints
- dkruse33856@direct.centracare.com
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba CentraCare - River Campus Clinic
- Multi-Specialty Clinic/Center
- Saint Cloud, MN
- NPI 1043212665
-
dba CentraCare - Plaza Clinic
- Multi-Specialty Clinic/Center
- Saint Cloud, MN
- NPI 1225030844
-
dba CentraCare Occupations Health
- Occupational Medicine Clinic/Center
- Saint Cloud, MN
- NPI 1366192759
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344470400000",
"number": "1982831210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "924 CELEBRATION CIR",
"city": "SARTELL",
"state": "MN",
"postal_code": "56377",
"telephone_number": "319-621-3732"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 CENTRACARE CIR",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563035000",
"telephone_number": "320-654-3610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRUSE",
"first_name": "DAVID",
"middle_name": "ALLEN",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-06-13",
"last_updated": "2012-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IA",
"license": "R-8721",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MN",
"license": "54831",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Cloud, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2012; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.