Active NPI
Kristin Magnuson Nord, M.D.
- Dermatology Physician
- New York, NY
National Provider Identifier
1043337801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 233383
- Practice address
- 161 Fort Washington Ave
12TH Floor, Room 1206a
New York, NY 10032-3729 - Phone
- (212) 305-5317
- Fax
- (212) 795-1859
- NPI assigned
- Mar 24, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 233383 | NY | Primary |
Addresses
Primary practice location
161 Fort Washington Ave
12TH Floor, Room 1206a
New York, NY 10032-3729
Mailing address
30 Waterside PLZ
Apt. 25E
New York, NY 10010-2622
Phone (212) 684-4409
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150603000203 | CA | Order and Referring Only - Dermatology | 3072794940 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 233383 | NY | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043337801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 WATERSIDE PLZ",
"address_2": "APT. 25E",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100102622",
"telephone_number": "212-684-4409",
"fax_number": "270-588-7138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "161 FORT WASHINGTON AVE",
"address_2": "12TH FLOOR, ROOM 1206A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100323729",
"telephone_number": "212-305-5317",
"fax_number": "212-795-1859"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NORD",
"first_name": "KRISTIN",
"middle_name": "MAGNUSON",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "NY",
"license": "233383",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.