Individual provider Active NPI

Kristina Jacquelyn St.Clair, D.O.

  • Infectious Disease Physician
  • Camp Pendleton, CA
National Provider Identifier
1083797948
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
0102202059 Issued in VA
Practice address
PO Box 555191
Camp Pendleton, CA 92055-5191
Phone
(760) 725-1213
NPI assigned
Oct 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 010220059 VA
Infectious Disease Physician 207RI0200X 0102202059 VA Primary

Addresses

Primary practice location

PO Box 555191
Camp Pendleton, CA 92055-5191

Mailing address

139 Douglas Avenue
Portsmouth, VA 23707
Phone (845) 216-2401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230410000465 VA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 9032348636

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
010220059VAMDInfectious Disease Physician
0102202059VAMDInfectious Disease Physician

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1083797948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 DOUGLAS AVENUE",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "23707",
            "telephone_number": "845-216-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 555191",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "920555191",
            "telephone_number": "760-725-1213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST.CLAIR",
        "first_name": "KRISTINA",
        "middle_name": "JACQUELYN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "VA",
            "license": "010220059",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "VA",
            "license": "0102202059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camp Pendleton, CA

Sources for this page

Verify at the official NPI Registry.