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DOUGLAS ANTHONY KRUSE MD
NPI 1194830661
Family Medicine in Belleville, IL

Active since August 21, 2006PECOS EnrolledAccepts Medicare Assignment
4500 MEMORIAL DR, BELLEVILLE, IL 62226(618) 257-6220 Get Directions Write a Review

NPPES record last updated: March 19, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 19, 2021, Dec 8, 2015 (2 updates tracked since 2015).

About Douglas Anthony Kruse Md NPPES

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

DOUGLAS ANTHONY KRUSE MD (NPI 1194830661) is an individual family medicine provider in Belleville, Illinois, licensed in Illinois (036-098255) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with St Johns Hospital, and is a graduate of University Of Illinois College Of Med (chi/peor/rock/chm-urb) (1995).

NPPES Registry Identity

NPI1194830661
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDOUGLAS ANTHONY KRUSECredential: MD
Location Address4500 MEMORIAL DRBelleville, IL 62226-5360
Mailing Address4500 Memorial DrBelleville, IL 62226-5360 · (618) 257-6220
Phone(618) 257-6220
Sole ProprietorNo
Medical School CMSUniversity Of Illinois College Of Med (chi/peor/rock/chm-urb)Graduated 1995
Enumeration DateAugust 21, 2006
Last NPPES UpdateMarch 19, 20212 updates tracked since enumeration
NPPES CertifiedMarch 19, 2021
✔ NPI 1194830661 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IL · 036-098255
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedHospitalistTaxonomy 208M00000X · License 036098255 (IL)
4500 MEMORIAL DR, Belleville, IL 62226
Open in Google Maps ↗

Other Identifiers 3

Other100888IL · Group Health Plan
Medicaid036-098255IL
Other01427671IL · Il Blueshield

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Douglas Anthony Kruse Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5294929444
PECOS Enrollment IDI20101101001357
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.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
128 services72 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
124 services107 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
93 services52 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
67 services59 patients
Nursing facility discharge management, more than 30 minutes 99316
Nursing facility discharge management over 30 minutes is a comprehensive process where a healthcare team prepares you for leaving the facility. It involves creating a tailored plan, coordinating care, and ensuring a smooth transition to your next care setting.
46 services43 patients
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
44 services39 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Johns Hospital

Acute Care Hospitals · Springfield, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140053
Location800 E Carpenter StSpringfield, IL 62769 · Sangamon County
Emergency services Birthing friendly

Memorial Medical Center

Acute Care Hospitals · Springfield, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140148
Location701 N First StSpringfield, IL 62702 · Sangamon County
Emergency services Birthing friendly

Carlinville Area Hospital

Critical Access Hospitals · Carlinville, IL
OwnershipVoluntary non-profit - Private
CMS Certification Number141347
Location20733 N Broad StreetCarlinville, IL 62626 · Macoupin County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62226 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
$88.44 typical visit price
range $56.28 – $173.35
Typical copayment $22.11 (range $14.07 – $43.33)
Most-billed visit code 99203
Established Patient
$99.71 typical visit price
range $17.51 – $139.99
Typical copayment $24.92 (range $4.37 – $34.99)
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.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
4 suppliers12 claims12 services$69.93 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

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

CEP AMERICA - ILLINOIS SNF, LLP
Internal Medicine (Infectious Disease)
4500 MEMORIAL DR
BELLEVILLE, IL 62226
St. Clair County (618) 233-7750
MS. LAUREN NICOLE MARSHALL FNP
Nurse Practitioner
4500 MEMORIAL DR
BELLEVILLE, IL 62226
St. Clair County (618) 257-5455
MR. LITO T RUFIN NP
Nurse Practitioner
4500 MEMORIAL DR
BELLEVILLE, IL 62226
St. Clair County (618) 257-6220
KIM C WRIGLEY P.A.
Physician Assistant
4500 MEMORIAL DR
BELLEVILLE, IL 62226
St. Clair County (618) 257-6220
BRIAN BENDEL
Nurse Anesthetist, Certified Registered
4500 MEMORIAL DR
BELLEVILLE, IL 62226
St. Clair County (561) 623-2008
DR. PAUL D SANDER MD
Pain Medicine (Pain Medicine)
4500 MEMORIAL DR, ANESTHESIA DEPT
BELLEVILLE, IL 62226
St. Clair County (618) 257-4076
DR. NEIL MCCLYMONT D.O.
Emergency Medicine
4500 MEMORIAL DR, MEMORIAL HOSPITAL - ER
BELLEVILLE, IL 62226
St. Clair County (618) 233-7750
DR. VIBHU DHAWAN MD
Internal Medicine
4500 MEMORIAL DR
BELLEVILLE, IL 62226
St. Clair County (618) 257-6220

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Douglas Kruse's NPI number?

The NPI number for Douglas Kruse is 1194830661. It was assigned to this individual provider in the NPPES registry on August 21, 2006.

Where is Douglas Kruse located?

Douglas Kruse practices at 4500 Memorial Dr, Belleville, IL 62226. The listed phone number is (618) 257-6220.

What is Douglas Kruse's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Douglas Kruse enrolled in Medicare?

Yes. Douglas Kruse is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Douglas Kruse affiliated with any hospitals?

According to CMS data, Douglas Kruse is affiliated with St Johns Hospital, Memorial Medical Center and Carlinville Area Hospital.

When was this NPI record last updated?

The NPPES record for Douglas Kruse was last updated on March 19, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.