Kristin Marie Theetge, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

16619 Issued in CA

Practice address

1010 W la Veta Ave Ste 610
Orange, CA 92868-4306

Phone

(714) 285-2311

Fax

(714) 285-2319

NPI assigned

Mar 5, 2007

Last updated

Feb 21, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 CA

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, 2006

Medicare assignment

May accept Medicare assignment

Group practices

Alex Zand MD a Professional CorporationGroup PAC ID 7719079144, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St. Joseph Hospital Hospital, Orange, CA, CCN 050069

Merit-based Incentive Payment System (MIPS)

Final score

91.45 of 100Reported as group

Quality

85.74

Promoting interoperability

100

Improvement activities

40

Cost

66.98

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

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

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.

• Alex Zand, MD a Professional Corporation

  • Internal Medicine Physician
  • Orange, CA
  • NPI 1922299023
  Medicare reassignment Care Compare group NPD
• St Jude Hospital Inc

  dba Providence St. Jude Medical Center

  • General Acute Care Hospital
  • Fullerton, CA
  • NPI 1194926279
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Joseph Hospital of Orange

  dba Providence St. Joseph Hospital

  • General Acute Care Hospital
  • Orange, CA
  • NPI 1912982216
  Care Compare affiliation
• St. Joseph Hospital of Orange

  dba Providence St. Joseph Hospital

  • General Acute Care Hospital
  • Orange, CA
  • NPI 1558575746
  Care Compare affiliation

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329782400000",
    "number": "1053440826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 W LA VETA AVE STE 610",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684306",
            "telephone_number": "714-285-2311",
            "fax_number": "714-285-2319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 W LA VETA AVE STE 610",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684306",
            "telephone_number": "714-285-2311",
            "fax_number": "714-285-2319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEETGE",
        "first_name": "KRISTIN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2012-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "16619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Queen RX Inc
• The Queen RX Inc
• The Regents of the University of California-Irvine (UC Irvine Hospitalist Program)
• The Wellness Center Central
• The Will
• Janis W Thereault, MD
• Jay Thomas Thetford, MD
• Aaron Hung Thi
• William N Thibault, MD
• Danielle Lee Thienes

• Adult Health Nurse Practitioner in Orange, CA
• Providers in Orange, CA by specialty
• Adult Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; 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.