Individual provider Active NPI

Cristina Quiroz, AGPCNP-BC

  • Gerontology Nurse Practitioner
  • Highland, IN
National Provider Identifier
1114744927
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
71015941A Issued in IN
Practice address
3100 45TH St Ste 4
Highland, IN 46322-3277
Phone
(219) 922-6911
Fax
(219) 922-6968
NPI assigned
Sep 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28278391A IN
Registered Nurse 163W00000X 28278391C IN
Gerontology Nurse Practitioner 363LG0600X 71015941A IN Primary

Addresses

Primary practice location

3100 45TH St Ste 4
Highland, IN 46322-3277

Mailing address

608 W 145TH St
East Chicago, IN 46312-3234

Other identifiers 2

IdentifierTypeStateIssuer
300098423MedicaidIN
1104472951OtherINANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20241010001103 IN Practitioner - Nurse Practitioner 6608308036 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
219 Health Network IncGroup PAC ID 0547521452, 70 clinicians

Practice addresses (Care Compare)

3100 45TH St
Highland, IN 46322-3289
Phone (219) 922-6911

Hospital & facility affiliations

  • Community Hospital Hospital, Munster, IN, CCN 150125
  • St Catherine Hospital Inc Hospital, East Chicago, IN, CCN 150008
  • St Mary Medical Center Inc Hospital, Hobart, IN, CCN 150034

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28278391AINMDRegistered Nurse
71015941AINMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
219 Health Network, Inc. CurrentSince Jan 15, 2025 Accepting new patients
219 Health Network Inc CurrentSince Jan 15, 2025 Accepting new patients
Midwest Post Acute Care PLLC CurrentSince Oct 1, 2024 Accepting new patients
219 Health Network, Inc. Past Accepting new patients

Locations

100 W Chicago Ave
Ste F
East Chicago, IN 46312
Phone (219) 392-7016

3100 45th St
Ste 4
Highland, IN 46322
Phone (219) 922-6911

3100 45th St
Highland, IN 46322
Phone (219) 922-6099

4410 W 49th Ave
Hobart, IN 46342
Phone (219) 942-3279

1750 S Creasy Ln
Lafayette, IN 47905
Phone (765) 447-6600

4100 N Morrison Rd
Muncie, IN 47304
Phone (765) 212-3162

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1727049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1114744927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 W 145TH ST",
            "city": "EAST CHICAGO",
            "state": "IN",
            "postal_code": "463123234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 45TH ST STE 4",
            "city": "HIGHLAND",
            "state": "IN",
            "postal_code": "463223277",
            "telephone_number": "219-922-6911",
            "fax_number": "219-922-6968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUIROZ",
        "first_name": "CRISTINA",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-23",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28278391A",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28278391C",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "71015941A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300098423",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "1104472951",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland, IN

Sources for this page

Verify at the official NPI Registry.