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DARYL L KRUSE OD
NPI 1659361772
Optometrist in Mount Pleasant, WI

Active since October 28, 2005PECOS EnrolledAccepts Medicare Assignment
80.46/100
CMS Quality Rating
5802 WASHINGTON AVE, MOUNT PLEASANT, WI 53406(414) 955-2020(414) 955-6300 Get Directions Write a Review

NPPES record last updated: September 25, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 25, 2019, Dec 12, 2016 (2 updates tracked since 2016).

About Daryl L Kruse Od NPPES

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

DARYL L KRUSE OD (NPI 1659361772) is an individual optometrist in Mount Pleasant, Wisconsin, licensed in Wisconsin (2442035) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS and is a graduate of Illinois College Of Optometry At Chicago (1991).

NPPES Registry Identity

NPI1659361772
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDARYL L KRUSECredential: OD
Location Address5802 WASHINGTON AVEMount Pleasant, WI 53406-4050
Mailing Address5802 Washington AveMount Pleasant, WI 53406-4050 · (414) 955-2020 · Fax (414) 955-6300
Phone(414) 955-2020
Fax(414) 955-6300
Sole ProprietorNo
Medical School CMSIllinois College Of Optometry At ChicagoGraduated 1991
Enumeration DateOctober 28, 2005
Last NPPES UpdateSeptember 25, 20192 updates tracked since enumeration
✔ NPI 1659361772 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in WI · 2442035
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
5802 WASHINGTON AVE, Mount Pleasant, WI 53406
Open in Google Maps ↗

Other Identifiers 2

Medicaid1659361772WI
Medicaid38583600WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, Network Health and more.Insurance ›

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

Daryl L Kruse Od 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 ID446311997
PECOS Enrollment IDI20081203000275
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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
615 services610 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
142 services122 patients
Imaging of optic nerve 92133
Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
80 services73 patients
Exam of visual field with extended testing 92083
An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
49 services46 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
48 services42 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
44 services44 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53406 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
$123.69 typical visit price
range $53.90 – $163.24
Typical copayment $30.92 (range $13.47 – $40.81)
Most-billed visit code 99204
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

80.46/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality66.24
Promoting Interoperability100
Improvement Activities40
Cost68.64

Reported Quality Measures

Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
100%56 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 13

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

HERSLOF'S, INC
Technician/Technologist (Optician)
5802 WASHINGTON AVE
RACINE, WI 53406
Racine County (262) 886-0443
DR. EDWARD CHENG DDS
Dentist (General Practice)
5802 WASHINGTON AVE, STE 202
RACINE, WI 53406
Racine County (262) 886-1957
DENNIS J KONTRA MD
Ophthalmology
5802 WASHINGTON AVE, STE 102
RACINE, WI 53406
Racine County (262) 886-9100
CHERYL WANG
Ophthalmology
5802 WASHINGTON AVE
MOUNT PLEASANT, WI 53406
Racine County (414) 955-2020
DR. LAWRENCE W PLATT M.D.
Ophthalmology
5802 WASHINGTON AVE
MOUNT PLEASANT, WI 53406
Racine County (414) 955-2020
ERIC HABBE MD
Ophthalmology
5802 WASHINGTON AVE
MOUNT PLEASANT, WI 53406
Racine County (262) 504-2700
SURGICENTER OF RACINE LTD
Clinic/Center (Ambulatory Surgical)
5802 WASHINGTON AVE, STE 204
RACINE, WI 53406
Racine County (261) 886-9100
FAMILY FOOT CLINICS OF WISCONSIN SC
Podiatrist (Foot & Ankle Surgery)
5802 WASHINGTON AVE, SUITE 103
RACINE, WI 53406
Racine County (262) 637-8806

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 Daryl Kruse's NPI number?

The NPI number for Daryl Kruse is 1659361772. It was assigned to this individual provider in the NPPES registry on October 28, 2005.

Where is Daryl Kruse located?

Daryl Kruse practices at 5802 Washington Ave, Mount Pleasant, WI 53406. The listed phone number is (414) 955-2020.

What is Daryl Kruse's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Daryl Kruse enrolled in Medicare?

Yes. Daryl 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.

What insurance does Daryl Kruse accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, Network Health and Providence Health Plan list Daryl Kruse as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Daryl Kruse was last updated on September 25, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.