Individual provider Active NPI

Christopher Edward Krukonis, PA-C

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1871095018
Registry record updated Mar 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
72 E Concord St
Boston, MA 02118-2307
Phone
(978) 998-9053
NPI assigned
Mar 4, 2018
Last updated
Mar 4, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2018

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 NU Primary

Addresses

Primary practice location

72 E Concord St
Boston, MA 02118-2307

Mailing address

206 Common LN
Prides Crossing, MA 01965-5413
Phone (978) 998-9053

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20200818000444 MA Practitioner - Physician Assistant 9234475815 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Boston University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New England Baptist Medical Associates, Inc.Group PAC ID 2365439783, 77 clinicians

Practice addresses (Care Compare)

125 Parker Hill Ave
Boston, MA 02120-2847
Phone (617) 754-5800

Hospital & facility affiliations

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: ckrukonis@aosm1214.srs-direct.com
  • Direct secure messaging: ckrukonis257137@direct.bilh.masshiway.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1520121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520121600000",
    "number": "1871095018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 COMMON LN",
            "city": "PRIDES CROSSING",
            "state": "MA",
            "postal_code": "019655413",
            "telephone_number": "978-998-9053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 E CONCORD ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182307",
            "telephone_number": "978-998-9053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUKONIS",
        "first_name": "CHRISTOPHER",
        "middle_name": "EDWARD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-04",
        "last_updated": "2018-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.