Krystalyn Rose Bates, DO

Primary specialty

Addiction Medicine (Preventive Medicine) PhysicianTaxonomy code 2083A0300X

License

73263 Issued in CT

Practice address

883 Paddock Ave
Meriden, CT 06450-7044

Phone

(203) 634-7020

NPI assigned

Jun 25, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Interoperability endpoints

• Direct secure messaging: krystalyn.bates@xdr.hhchealthdirect.org

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

{
    "created_epoch": "1561420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1053972695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 ATLANTIC AVE APT 1",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908134580",
            "telephone_number": "916-206-9459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "883 PADDOCK AVE",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064507044",
            "telephone_number": "203-634-7020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATES",
        "first_name": "KRYSTALYN",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-25",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "CT",
            "license": "73263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ana Cristina Barreiro, MFT-A
• Claire Elizabeth Bart, OTR/L
• Stephanie Marie Basister, COTA
• Sarah Elizabeth Basta, PHARM.D. BCGP
• Cecilia Bates, LPC
• Lauren Ashley Bauer, OTR/L
• Maria Beaudoin, PHARMD
• Ebisa Y Bekele, MD
• Kristina Belevich, LCSW
• Jocelynne N. Bell

• All providers in Meriden, CT
• Addiction Medicine (Preventive Medicine) Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2023; 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.

Verify at the official NPI Registry.