Individual provider Active NPI

Eneida Crespo, CBHCMS

  • Case Manager/Care Coordinator
  • Boca Raton, FL
National Provider Identifier
1093385221
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
22018 Ensenada Way
Boca Raton, FL 33433-4611
Phone
(954) 907-6263
NPI assigned
Jun 29, 2021
Last updated
Jun 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X FL
Case Manager/Care Coordinator 171M00000X FL Primary

Addresses

Primary practice location

22018 Ensenada Way
Boca Raton, FL 33433-4611

Mailing address

22018 Ensenada Way
Boca Raton, FL 33433-4611
Phone (954) 907-6263

Other identifiers 1

IdentifierTypeStateIssuer
109672100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1093385221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22018 ENSENADA WAY",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334334611",
            "telephone_number": "954-907-6263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22018 ENSENADA WAY",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334334611",
            "telephone_number": "954-907-6263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRESPO",
        "first_name": "ENEIDA",
        "credential": "CBHCMS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109672100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.