Individual provider Active NPI

Jessica Krupinski, PA

  • Physician Assistant
  • Watertown, WI
National Provider Identifier
1104415835
Registry record updated Oct 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5387-23 Issued in WI
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

Updated by the provider on Oct 31, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
100185207MedicaidWI
1104415835MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211103002251 WI Practitioner - Physician Assistant 7810385234 Reassigns benefits to 1 organization

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
Weight in Gold Wellness SCGroup PAC ID 6305202110, 10 clinicians

Practice addresses (Care Compare)

123 Hospital Dr
Suite 212
Watertown, WI 53098-3336
Phone (920) 471-4044

Hospital & facility affiliations

  • Watertown Memorial Hospital Hospital, Watertown, WI, CCN 520116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5387WIMDChiropractor
5387-23WIMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: 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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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

Verify at the official NPI Registry.