Individual provider Active NPI

Juliane Margaret Krasicki, PA-C

  • Physician Assistant
  • Hartford, CT
National Provider Identifier
1356606008
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
002762 Issued in CT
Practice address
80 Seymour Street
Hartford Hospital Surgery Dept
Hartford, CT 06102-5037
Phone
(860) 972-4219
NPI assigned
Jul 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

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 002762 CT Primary

Addresses

Primary practice location

80 Seymour Street
Hartford Hospital Surgery Dept
Hartford, CT 06102-5037

Mailing address

99 Deerwood Rd
Tolland, CT 06084
Phone (860) 759-0826

Other identifiers 1

IdentifierTypeStateIssuer
003027820MedicaidCT

Other names 1

  • Juliane Margaret Campbell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20121019000018 CT Practitioner - Physician Assistant 1254581713 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford HospitalGroup PAC ID 2567366016, 1,040 clinicians

Practice addresses (Care Compare)

80 Seymour St
Hartford, CT 06102-8000

Merit-based Incentive Payment System (MIPS)

Final score
92.63 of 100Reported as group
Quality
75.35
Promoting interoperability
100
Improvement activities
40
Cost
71.44

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002762CTMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Hospital CurrentSince Aug 12, 2012 Accepting new patients
Hartford Hospital CurrentSince Aug 12, 2012 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1341792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1356606008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 DEERWOOD RD",
            "city": "TOLLAND",
            "state": "CT",
            "postal_code": "06084",
            "telephone_number": "860-759-0826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 SEYMOUR STREET",
            "address_2": "HARTFORD HOSPITAL SURGERY DEPT",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061025037",
            "telephone_number": "860-972-4219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRASICKI",
        "first_name": "JULIANE",
        "middle_name": "MARGARET",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-09",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "002762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003027820",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIANE",
            "last_name": "CAMPBELL",
            "middle_name": "MARGARET",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.