Individual provider Active NPI

Craig Krupansky, PA-C

  • Physician Assistant
  • Atlanta, GA
National Provider Identifier
1477976538
Registry record updated Feb 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7093 Issued in GA
Practice address
5673 Peachtree Dunwoody Rd Ste 825
Atlanta, GA 30342-1771
Phone
(404) 255-5595
Fax
(404) 252-2780
NPI assigned
Jan 27, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2014

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 7093 GA Primary

Addresses

Primary practice location

5673 Peachtree Dunwoody Rd Ste 825
Atlanta, GA 30342-1771

Mailing address

5673 Peachtree Dunwoody Rd Ste 825
Atlanta, GA 30342-1771
Phone (404) 255-5595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20160425001189 GA Practitioner - Physician Assistant 2769781806 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Emergency Associates, P.C.Group PAC ID 9335135144, 41 clinicians

Practice addresses (Care Compare)

450 Northside Cherokee Blvd
Canton, GA 30115-8015
Phone (770) 224-1000

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7093GAMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: ckrupansky44726@direct.emory.org

Organizations & group practices 4

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": "1390780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392249600000",
    "number": "1477976538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5673 PEACHTREE DUNWOODY RD STE 825",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421771",
            "telephone_number": "404-255-5595",
            "fax_number": "404-252-2780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5673 PEACHTREE DUNWOODY RD STE 825",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421771",
            "telephone_number": "404-255-5595",
            "fax_number": "404-252-2780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUPANSKY",
        "first_name": "CRAIG",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-27",
        "last_updated": "2014-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "7093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.