Physician Compare National (NPI:1407966658)

HEALTHCARE PROVIDER: JOSEPH JOHN KRUPKA O.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1407966658
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5193809010
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080229000538
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KRUPKA
	Individual professional last name
Provider First Name	JOSEPH
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
	Individual professional's medical school
Graduation Year	1994
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	955 N MUTUAL WAY
	Group Practice or individual's line 1 address
City	APPLETON
	Group Practice or individual's city
State	WI
	Group Practice or individual's state
Zip Code	549138415
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9209546600
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y