Dorothy Delisfort-Crisostomo, FNP-C

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN141244 Issued in GA

Practice address

4228 1St Ave Ste 1
Tucker, GA 30084-4426

Phone

(833) 583-4778

Fax

(833) 583-4779

NPI assigned

Nov 28, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dorothy Delisfort Other name

Medicare fee-for-service enrollment

Enrolled in GA, WA, FL3 enrollments

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 3

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Nurse Practitioner

Practice roles

Locations

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.

• U-First Healthcare LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Tucker, GA
  • NPI 1205375862

  Family, FL, GA, WA

  Medicare reassignment NPD Authorized official
• The Southeast Permanente Medical Group

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1245266956

  GA

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1480291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1013450816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4228 1ST AVE STE 1",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844426",
            "telephone_number": "833-583-4778",
            "fax_number": "833-583-4779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4228 1ST AVE STE 1",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844426",
            "telephone_number": "833-583-4778",
            "fax_number": "833-583-4779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELISFORT-CRISOSTOMO",
        "first_name": "DOROTHY",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-28",
        "last_updated": "2024-04-15",
        "certification_date": "2023-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN141244",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN141244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DOROTHY",
            "last_name": "DELISFORT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Dekalb Community Service Board
• Dekalb Community Service Board
• Dekalb County Board of Commissioners
• Dekalb Internal Medicine Associates, PC
• Dekalb Pediatric Associates PC
• Patricia L Delk Sr., DDS
• Patrick Dent, CPSAD,CPSMH
• Kacie Dentleegrand
• Denture Place LLC
• Valerie Deriso

• All providers in Tucker, GA
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.