Active NPI
Daniel J Kruse, MD
- Family Medicine Physician
- St Charles, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036098663
- Practice address
- 2900 Foxfield Rd
Suite 200
St Charles, IL 60174-5799 - Phone
- (630) 377-7900
- Fax
- (630) 377-8007
- NPI assigned
- Jul 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036098663 | IL | Primary |
Addresses
Primary practice location
2900 Foxfield Rd
Suite 200
St Charles, IL 60174-5799
Mailing address
2900 Foxfield Rd
Suite 200
St Charles, IL 60174-5799
Phone (630) 377-7900
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036098663 | Medicaid | IL | |
| 363149833 | Other | IL | TAX IDENTIFICATION NUMBER |
| 3631498336019001 | Other | IL | CDPG HFS PAYEE ID |
| 0222075 | Other | IL | BLUE CRSS GROUP NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040304001109 | IL | Practitioner - Family Practice | 3476441221 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Nebraska College of Medicine, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Central Dupage Physician Group
Practice addresses (Care Compare)
1800 N Main St
Wheaton, IL 60187-3112
Phone (630) 933-4800
2900 Foxfield Rd
St Charles, IL 60174-5799
300 Randall Rd
Geneva, IL 60134-4200
Phone (630) 933-4700
304 Randall Rd
Geneva, IL 60134-4200
Phone (630) 307-7799
Hospital & facility affiliations
- Resilience Home Health, LLC
- Northwestern Medicine Central Dupage Hospital
- Northwestern Medicine Delnor Community Hospital
- Northwestern Medicine Kishwaukee Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.63 of 100
- Quality
- 88.47
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Dupage Physician Group | Current | Accepting new patients | |
| Central Dupage Physician Group | Family Medicine | Current | Accepting new patients |
Locations
Dept 5777
Carol Stream, IL 60122
Carol Stream, IL 60122
Phone (630) 933-3300
2900 Foxfield Rd
Ste 200
St Charles, IL 60174
Phone (630) 377-7900
2900 Foxfield Rd
Ste 307
St Charles, IL 60174
Phone (630) 208-3200
1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045
25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600
Organizations & group practices 4
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.
-
- Family Medicine Physician
- Carol Stream, IL
- NPI 1033149844
Family Medicine, IL
-
- Orthopaedic Surgery Physician
- Glen Ellyn, IL
- NPI 1477897833
-
- Durable Medical Equipment & Medical Supplies
- Warrenville, IL
- NPI 1841534203
-
- Orthopaedic Surgery Physician
- Geneva, IL
- NPI 1780012344
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Winfield, IL
- NPI 1003864810
Hospital
-
- Home Health Agency
- Aurora, IL
- NPI 1912107517
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1365552000000",
"number": "1992736284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2900 FOXFIELD RD",
"address_2": "SUITE 200",
"city": "ST CHARLES",
"state": "IL",
"postal_code": "601745799",
"telephone_number": "630-377-7900",
"fax_number": "630-377-8007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2900 FOXFIELD RD",
"address_2": "SUITE 200",
"city": "ST CHARLES",
"state": "IL",
"postal_code": "601745799",
"telephone_number": "630-377-7900",
"fax_number": "630-377-8007"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRUSE",
"first_name": "DANIEL",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-05",
"last_updated": "2013-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036098663",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036098663",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX IDENTIFICATION NUMBER",
"identifier": "363149833",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CDPG HFS PAYEE ID",
"identifier": "3631498336019001",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CRSS GROUP NUMBER",
"identifier": "0222075",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in St Charles, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2013; 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.