Individual provider Active NPI

Cristalle Haye, APRN

  • Family Nurse Practitioner
  • Deerfield Beach, FL
National Provider Identifier
1013644582
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11014097 Issued in FL
Practice address
677 Trace Cir
Deerfield Beach, FL 33441-8121
Phone
(954) 363-1011
NPI assigned
Aug 4, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11014097 FL Primary

Addresses

Primary practice location

677 Trace Cir
Deerfield Beach, FL 33441-8121

Mailing address

677 Trace Cir Apt 210
Deerfield Beach, FL 33441-7802
Phone (954) 363-1011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20220926001386 FL Practitioner - Nurse Practitioner 9931585148 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11014097FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fernando M Lopez-Ivern MD Inc CurrentSince Aug 19, 2022 Accepting new patients
Medicus Health Plan, Inc. Past Accepting new patients

Locations

9980 Central Park Blvd N
Ste 116
Boca Raton, FL 33428
Phone (561) 448-1880

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GEABED/Endpoint/GEABED

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1659571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1013644582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "677 TRACE CIR APT 210",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334417802",
            "telephone_number": "954-363-1011",
            "fax_number": "954-531-0703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 TRACE CIR",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334418121",
            "telephone_number": "954-363-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYE",
        "first_name": "CRISTALLE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-04",
        "last_updated": "2022-08-04",
        "certification_date": "2021-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11014097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield Beach, FL

Sources for this page

Verify at the official NPI Registry.