Individual provider Active NPI

Kristopher Krysa, OTR

  • Occupational Therapist
  • Milwaukee, WI
National Provider Identifier
1417676776
Registry record updated Jun 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
31007766A Issued in IN
Practice address
10150 W National Ave Ste 390
Milwaukee, WI 53227-2145
Phone
(414) 545-4430
NPI assigned
Aug 22, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 31007766A IN Primary

Addresses

Primary practice location

10150 W National Ave Ste 390
Milwaukee, WI 53227-2145

Mailing address

10150 W National Ave Ste 390
Milwaukee, WI 53227-2145
Phone (414) 545-4430

Other practice location 1

7901 E 88th St
Indianapolis, IN 46256-1235
Phone (317) 849-5437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
31007766AINMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Psyche, LLC CurrentSince Jun 11, 2023 Accepting new patients
ABA Programming Inc. CurrentSince Jan 12, 2025 Accepting new patients

Locations

7901 E 88th St
Indianapolis, IN 46256
Phone (317) 842-5437

10150 W National Ave
Ste 390
West Allis, WI 53227
Phone (414) 454-4430

Organizations & group practices 2

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": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685836800000",
    "number": "1417676776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10150 W NATIONAL AVE STE 390",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532272145",
            "telephone_number": "414-545-4430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10150 W NATIONAL AVE STE 390",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532272145",
            "telephone_number": "414-545-4430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7901 E 88th St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462561235",
            "country_code": "US",
            "telephone_number": "317-849-5437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRYSA",
        "first_name": "KRISTOPHER",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-22",
        "last_updated": "2023-06-04",
        "certification_date": "2023-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31007766A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.