Krystal Marie Disantis, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN.CNP.0233204 Issued in OH

Practice address

731 N Clyde Morris Blvd
Daytona Beach, FL 32114-1603

Phone

(786) 738-9144

Fax

(877) 245-1597

NPI assigned

Sep 23, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cardiac Vision LLCGroup PAC ID 9032349733, 66 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

79.1 of 100Reported as group

Quality

35.98

Promoting interoperability

100

Improvement activities

40

Cost

61.02

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Cardiac Vision LLC

  • Cardiovascular Disease Physician
  • Jacksonville, FL
  • NPI 1144651373
  Medicare reassignment Care Compare group NPD
• Conviva Medical Center Management LLC

  • Internal Medicine Physician
  • Miami, FL
  • NPI 1649324278
  Medicare reassignment NPD
• D.H. Medical, LLC

  • Family Medicine Physician
  • Port Orange, FL
  • NPI 1477855815
  Medicare reassignment NPD

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

{
    "created_epoch": "1537660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1033693288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 BLUE LAGOON DR STE 400",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331262051",
            "telephone_number": "305-500-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321141603",
            "telephone_number": "786-738-9144",
            "fax_number": "877-245-1597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISANTIS",
        "first_name": "KRYSTAL",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-23",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.0233204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nichole Eileen Dinda, COTA/L
• Michael Doughney Dineen, MD
• Paul Dinella Dinella, LCSW
• Direct Therapy Services LLC
• Disability Solutions for Independent Living, Inc.
• Dispatchhealth-Florida Inc.
• Divine Blessings
• Marisha Lasha Dixon, APRN
• Cloressa Dizney, ARNP
• DK & Sons Transportation

• Nurse Practitioner in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; 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.