Krupa Andalkar, P.A.-C
Individual provider Active NPI Surgical Physician Assistant · Chicago, IL
NPI 1043594872 · NPPES record last updated Oct 17, 2011
Key facts
- NPI
- 1043594872
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Physician Assistant 363AS0400X
- License
- 085004088 (IL)
- Practice address
- 5841 S Maryland Ave
Chicago, IL 60637-1447 - Phone
- (773) 702-2123
- NPI assigned
- Sep 28, 2011
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- University of Chicago
Practice addresses (Care Compare)
5841 S Maryland Ave
Chicago, IL 60637-1443
Phone (888) 824-0200
Hospital & facility affiliations
- The University of Chicago Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120322000407 | IL | Practitioner - Physician Assistant | 1153581590 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085004088 | IL | MD | Surgical Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 085004088 | IL | Yes |
Addresses
Primary practice location
5841 S Maryland Ave
Chicago, IL 60637-1447
Mailing address
2400 N Lakeview Ave Apt 1011
Chicago, IL 60614-2736
Phone (510) 468-5865
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All providers in Chicago, IL · Surgical Physician Assistant in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.