JORDAN KATSUMI KRUSE RN, FNP
NPI 1154204378
Nurse Practitioner - Primary Care in Willits, CA

Q: What is Jordan Kruse's NPI number?

The NPI number for Jordan Kruse is 1154204378. It was assigned to this individual provider in the NPPES registry on July 26, 2025.

Q: What is Jordan Kruse's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Q: When was this NPI record last updated?

The NPPES record for Jordan Kruse was last updated on July 26, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 26, 2025PECOS Enrolled

1245 S MAIN ST, WILLITS, CA 95490(760) 496-8102 Get Directions Write a Review

NPPES record last updated: July 26, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Jordan Katsumi Kruse Rn, Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JORDAN KATSUMI KRUSE RN, FNP (NPI 1154204378) is an individual primary care provider in Willits, California, licensed in California (95030155) and active in the NPI registry since July 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154204378

Entity TypeIndividualMale

Primary Taxonomy363LP2300X

Provider Legal NameJORDAN KATSUMI KRUSECredential: RN, FNP

Location Address1245 S MAIN STWillits, CA 95490-4305

Mailing Address31262 Pudding Creek Rd Unit BFort Bragg, CA 95437-8155 · (760) 496-8102

Phone(760) 496-8102

Sole ProprietorNo

Enumeration DateJuly 26, 2025

NPPES CertifiedJuly 26, 2025

✔ NPI 1154204378 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP2300X

License✔ Licensed in CA · 95030155

Also ListedRegistered Nurse · General PracticeTaxonomy 163WG0000X · License 95135914 (CA)

1245 S MAIN ST, Willits, CA 95490

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jordan Katsumi Kruse Rn, Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95490 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$90.32 typical visit price

range $58.87 – $176.60

Typical copayment $22.58 (range $14.71 – $44.15)

Most-billed visit code 99203

Established Patient

$103.36 typical visit price

range $19.28 – $144.60

Typical copayment $25.84 (range $4.82 – $36.15)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MISS MIRIAM IDA HARRIS M.D.

Family Medicine