Individual provider Active NPI

Faith Mary Crumpler, MD

  • Family Medicine Physician
  • Burlingame, CA
National Provider Identifier
1154584829
Registry record updated Oct 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A115514 Issued in CA
Practice address
329 Primrose Rd FL 2
Burlingame, CA 94010-4093
Phone
(650) 288-1200
Fax
(650) 288-4180
NPI assigned
Jul 3, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5315037548 MI
Family Medicine Physician 207Q00000X A115514 CA Primary

Addresses

Primary practice location

329 Primrose Rd FL 2
Burlingame, CA 94010-4093

Mailing address

130 Sutter St FL 2
San Francisco, CA 94104-4009
Phone (415) 658-6791

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20150413000778 CA Practitioner - Family Practice 0446578991 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A115514CAMDFamily Medicine Physician
5315037548MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifelong Medical Care Family Medicine CurrentSince Mar 18, 2015 Accepting new patients
Lifelong Medical Care CurrentSince Mar 18, 2015 Accepting new patients

Locations

3260 Sacramento St
Berkeley, CA 94702
Phone (510) 428-4500

2344 6th St
Berkeley, CA 94710
Phone (510) 981-3203

10700 MacArthur Blvd
Ste 14B
Oakland, CA 94605
Phone (510) 563-4300

616 16th St
Oakland, CA 94612
Phone (510) 451-1273

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540252800000",
    "number": "1154584829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 SUTTER ST FL 2",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941044009",
            "telephone_number": "415-658-6791",
            "fax_number": "415-520-0904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 PRIMROSE RD FL 2",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940104093",
            "telephone_number": "650-288-1200",
            "fax_number": "650-288-4180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUMPLER",
        "first_name": "FAITH",
        "middle_name": "MARY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-03",
        "last_updated": "2018-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5315037548",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A115514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlingame, CA

Sources for this page

Verify at the official NPI Registry.