DR. KURT BRUKSCH D.D.S.
NPI 1154339448
Dentist - Oral and Maxillofacial Surgery in Crystal Lake, IL
NPI Status: Active since August 03, 2006
Contact Information
690 NORTH ROUTE #31
CRYSTAL LAKE, IL
ZIP 60012
Phone: (815) 459-5600
Fax: (815) 459-5601
- Individual
- Male
- Dentist
- Oral and Maxillofacial Surgery
- Opted-Out Medicare
About KURT BRUKSCH
This page provides the complete NPI Profile along with additional information for Kurt Bruksch, a provider established in Crystal Lake, Illinois with a medical specialization in Dentist, focusing in oral and maxillofacial surgery . The healthcare provider is registered in the NPI registry with number 1154339448 assigned on August 2006. The practitioner's primary taxonomy code is 1223S0112X with license number 3721 (WI). The provider is registered as an individual and his NPI record was last updated 15 years ago.
- NPI
- 1154339448
- Provider Name
- DR. KURT BRUKSCH D.D.S.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 690 NORTH ROUTE #31 CRYSTAL LAKE, IL 60012
- Location Phone
- (815) 459-5600
- Location Fax
- (815) 459-5601
- Mailing Address
- 690 NORTH ROUTE #31 CRYSTAL LAKE, IL 60012
- Mailing Phone
- (815) 459-5600
- Mailing Fax
- (815) 459-5601
- Is Sole Proprietor?
- No
- Enumeration Date
- 08-03-2006
- Last Update Date
- 06-23-2010
- Code Navigator
A dentist like Kurt Bruksch is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Kurt Bruksch opted out of Medicare effective on 05-24-2022 until 05-24-2026. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare and cannot order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dentist Oral and Maxillofacial Surgery
- Taxonomy Code
- 1223S0112X
- Type
- Dental Providers
- License No.
- 3721
- License State
- WI
- Taxonomy Description
- An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 1223S0112X | Dental Providers | Dentist | 019018137 (IL) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| T38692 | MEDICARE UPIN (02) | WI | |
| 76484 | MEDICARE ID-TYPE UNSPECIFIED (04) | WI | |
| 761910 | MEDICARE ID-TYPE UNSPECIFIED (04) | IL |
Medicare Participation & PECOS Enrollment Status
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 05-24-2022
Opt-Out End Date: 05-24-2026
Eligible to Order and Refer? No
Reviews for DR. KURT BRUKSCH D.D.S.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 5 | 4 | 3 | 3 | 9 | 4 | 4 | 8 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 10 | 4 | 6 | 3 | 18 | 4 | 8 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 1 + 0 + 4 + 6 + 3 + 1 + 8 + 4 + 8 + 24 = 62 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 62 = 8 | 8 | ||||||||
The NPI number 1154339448 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1154339448, enumerated in the NPI registry as an "individual" on August 03, 2006
The provider is located at 690 North Route #31 Crystal Lake, Il 60012 and the phone number is (815) 459-5600
The provider's speciality is Dentist with taxonomy code 1223S0112X with a focus in Oral and Maxillofacial Surgery
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
No, the provider signed an affidavit on May 24, 2022 to opt-out of the Medicare program. The provider is excluded from the Medicare program until May 24, 2026.
This NPI record was last updated on August 03, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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