Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ida Kruse, PA-C

Individual provider Physician Assistant · NPI 1710409214

Ida Kruse, PA-C is a Physician Assistant in Wakefield, Rhode Island. Qualified in 2017, 9 years ago. Practices with Affinity Physicians LLC, a 734-clinician group and accepts Medicare assignment. Licensed in Rhode Island.

Years since qualifying
9
Licensed in
RI
In the registry since
2017
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1 High St
Wakefield, RI 02879-3103
Phone: (401) 789-1422
Fax: (401) 782-6810
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA00985 (RI)

Record details

NPI number1710409214
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 17, 2017
Last updated in NPPESJuly 17, 2017

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Affinity Physicians Llc. — 734 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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