Active NPI
Jessica Krupinski, PA
- Physician Assistant
- Watertown, WI
National Provider Identifier
1104415835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5387-23
- Practice address
- 123 Hospital Dr Ste 212
Watertown, WI 53098-3336 - Phone
- (920) 471-4044
- NPI assigned
- Jan 17, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5387-23 | WI | Primary |
Addresses
Primary practice location
123 Hospital Dr Ste 212
Watertown, WI 53098-3336
Mailing address
PO Box 735044
Chicago, IL 60673-5044
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100185207 | Medicaid | WI | |
| 1104415835 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ | ||
| Direct Messaging Address | jkrupinski372364@direct.myadvocateaurora.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
123 Hospital Dr
Suite 212
Watertown, WI 53098-3336
Phone (920) 471-4044
Hospital & facility affiliations
- Watertown Memorial Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5387 | WI | MD | Chiropractor |
| 5387-23 | WI | MD | Physician Assistant |
Interoperability endpoints
- jessica.krupinski.1@28527.direct.athenahealth.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Obesity Medicine (Family Medicine) Physician
- Watertown, WI
- NPI 1740996602
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Watertown, WI
- NPI 1992776041
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761868800000",
"number": "1104415835",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 735044",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606735044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 HOSPITAL DR STE 212",
"city": "WATERTOWN",
"state": "WI",
"postal_code": "530983336",
"telephone_number": "920-471-4044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRUPINSKI",
"first_name": "JESSICA",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-01-17",
"last_updated": "2025-10-31",
"certification_date": "2025-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WI",
"license": "5387-23",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100185207",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1104415835",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "215 Washington St",
"city": "Grafton",
"state": "WI",
"country_code": "US",
"postal_code": "530241700",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jkrupinski372364@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "215 Washington St",
"city": "Grafton",
"state": "WI",
"country_code": "US",
"postal_code": "530241700",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Watertown, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.