Douglas Krysan, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA057239 Issued in PA

Practice address

1725 W Harrison St Ste 161
Chicago, IL 60612-3861

Phone

(312) 563-2875

NPI assigned

Nov 5, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rush University Medical Center Hospital, Chicago, IL, CCN 140119
• Rush Oak Park Hospital Hospital, Oak Park, IL, CCN 140063

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dkrysan148118@direct.rush.rush-health.com

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.

• Rush University Medical Group

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1093819542
  Medicare reassignment Care Compare group NPD
• Rush University Medical Center

  • Internal Medicine Physician
  • Oak Brook, IL
  • NPI 1801375696
  NPD
• Rush University Medical Center

  • Cardiovascular Disease Physician
  • Chicago, IL
  • NPI 1578584140
  NPD (past)

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

• Rush Oak Park Hospital Inc

  • General Acute Care Hospital
  • Oak Park, IL
  • NPI 1558391706
  Care Compare affiliation
• Rush University Medical Center

  • Children's Hospital
  • Chicago, IL
  • NPI 1801908728
  Care Compare affiliation
• Rush University Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1932213600
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1415145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1316343296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST STE 161",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123861",
            "telephone_number": "312-563-2875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST STE 161",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123861",
            "telephone_number": "312-563-2875"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2113 Manor Ridge Dr",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "PA",
            "postal_code": "176034215",
            "country_code": "US",
            "telephone_number": "717-299-4644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRYSAN",
        "first_name": "DOUGLAS",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-05",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA057239",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085006546",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Rae Kruzan, RDN
• Kaylee Kruzan
• Alexandra Nicole Kruzel, R.D.N.
• Piana Krymskaya, OD
• Mariusz Krypczyk
• Renee Januchowski Kryscio, CRNA
• Erika Krysiak
• Krystle Grandberry DMD PLLC
• Katy Krystyniak
• Marek Krysztofiak

• Medical Physician Assistant in Chicago, IL
• Providers in Chicago, IL by specialty
• Medical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.

Verify at the official NPI Registry.