Individual provider Active NPI

Krasimir M Hristov, CNP

  • Nurse Practitioner
  • Roswell, NM
National Provider Identifier
1013296938
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
CNP-03573 Issued in NM
Practice address
400 E College Blvd Ste E
Roswell, NM 88201-7570
Phone
(575) 623-3155
Fax
(915) 587-6324
NPI assigned
Aug 9, 2011
Last updated
Oct 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X CNP-03573 NM Primary

Addresses

Primary practice location

400 E College Blvd Ste E
Roswell, NM 88201-7570

Mailing address

400 E College Blvd Ste E
Roswell, NM 88201-7570
Phone (575) 623-3155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20180924001704 NM Practitioner - Nurse Practitioner 8022238302 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

400 E College Blvd
Suite E
Roswell, NM 88201-7570
Phone (575) 623-3155

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
27.11 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
90.35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP-03573NMMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Atlas Medical LLC Multi-Specialty CurrentSince Jun 9, 2025 Accepting new patients
Reinecke Medical and Chiropractic Center Multi-Specialty CurrentSince Jul 24, 2018 Accepting new patients

Locations

400 E College Blvd
Ste E
Roswell, NM 88201
Phone (575) 623-3155

602 E College Blvd
Roswell, NM 88201
Phone (575) 623-3155

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1610/brand/1/csg/64/fhir/r4

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

Hospital & facility affiliations 4

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": "1312848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1013296938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E COLLEGE BLVD STE E",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882017570",
            "telephone_number": "575-623-3155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E COLLEGE BLVD STE E",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882017570",
            "telephone_number": "575-623-3155",
            "fax_number": "915-587-6324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HRISTOV",
        "first_name": "KRASIMIR",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-09",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "CNP-03573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, NM

Sources for this page

Verify at the official NPI Registry.