NPIMap

Organization Active NPI

Crossover Health Medical Group

  • Multi-Specialty Clinic/Center
  • Duncanville, TX
National Provider Identifier
1053939140
Registry record updated Jul 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
CROSSOVER HEALTH MEDICAL GROUP
Practice address
215 W Camp Wisdom Rd Ste 11
Duncanville, TX 75116-3342
Phone
(949) 891-0328
NPI assigned
Jul 6, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2020

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

Authorized official

Name
Angie Sakioka
Title
HR Operations Specialist
Phone
(949) 891-0228

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

215 W Camp Wisdom Rd Ste 11
Duncanville, TX 75116-3342

Mailing address

101 W Avenida Vista Hermosa Ste 120
San Clemente, CA 92672-7707
Phone (949) 891-0328

Other names 1

  • Crossover @ Duncanville Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2194163Crossover Health Medical Group, Apc215 W Camp Wisdom Rd Suite 11, Duncanville, TX 75116Certificate of waiverSep 28, 2026

National Provider Directory

National Provider Directory
Tax ID family
Crossover Medical Group89 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

215 W Camp Wisdom Rd
Ste 11
Duncanville, TX 75116

NPI Registry JSON

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

{
    "created_epoch": "1593993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593993600000",
    "number": "1053939140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W AVENIDA VISTA HERMOSA STE 120",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926727707",
            "telephone_number": "949-891-0328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 W CAMP WISDOM RD STE 11",
            "city": "DUNCANVILLE",
            "state": "TX",
            "postal_code": "751163342",
            "telephone_number": "949-891-0328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSOVER HEALTH MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-06",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A",
        "authorized_official_last_name": "SAKIOKA",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_title_or_position": "HR OPERATIONS SPECIALIST",
        "authorized_official_telephone_number": "949-891-0228"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crossover @ Duncanville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Duncanville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.