Individual provider Active NPI

Elizabeth Crisostomo Min, NP-C

  • Adult Health Nurse Practitioner
  • Palo Alto, CA
National Provider Identifier
1205129236
Registry record updated Jun 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
20645 Issued in CA
Practice address
795 El Camino Real
Palo Alto, CA 94301-2302
Phone
(650) 853-2916
NPI assigned
May 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 794542 CA
Adult Health Nurse Practitioner 363LA2200X 20645 CA Primary

Addresses

Primary practice location

795 El Camino Real
Palo Alto, CA 94301-2302

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408
Phone (650) 853-2916

Other practice location 1

701 E. El Camino Real
Mountain View, CA 94040-2833
Phone (650) 934-7090

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141206000407 CA Practitioner - Nurse Practitioner 0749502573 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, shared by 16 NPIs, 3,783 clinicians

Practice addresses (Care Compare)

100 S San Mateo Dr
San Mateo, CA 94401-3805
Phone (650) 696-5400

123 S San Mateo Dr
San Mateo, CA 94401-3804
Phone (650) 343-4200

2500 Grant Rd
Mountain View, CA 94040-4302
Phone (650) 940-7000

370 Distel Cir
Los Altos, CA 94022-1404
Phone (650) 254-5200

50 S San Mateo Dr
San Mateo, CA 94401-3857
Phone (650) 652-8500

795 El Camino Real
Palo Alto, CA 94301-2302
Phone (415) 600-1020

Hospital & facility affiliations

  • Peninsula Medical Center Hospital, Burlingame, CA, CCN 050007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20645CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Aug 1, 2016 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Aug 1, 2016 Accepting new patients
Sutter Bay Medical Foundation Current Accepting new patients
Sutter Bay Medical Foundation CurrentSince Aug 1, 2016 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Aug 1, 2016 Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
Sequoia Health Services Past Accepting new patients

Locations

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

715 Altos Oaks Dr
Los Altos, CA 94024
Phone (650) 934-7010

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977

701 E El Camino Real
#1
Mountain View, CA 94040
Phone (650) 404-8440

2350 W El Camino Real
Fl 2
Mountain View, CA 94040
Phone (650) 691-6174

701 E El Camino Real
Mountain View, CA 94040
Phone (650) 404-8370

795 El Camino Real
#1112
Palo Alto, CA 94301

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

301 Industrial Rd
#1
San Carlos, CA 94070
Phone (650) 404-8455

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

50 S San Mateo Dr
Ste 280
San Mateo, CA 94401
Phone (650) 342-5667

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

Interoperability endpoints

  • Direct secure messaging: emin347563@hisp.ehr.sutterhealth.org

Organizations & group practices 7

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 2

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": "1306195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591228800000",
    "number": "1205129236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "650-853-2916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 EL CAMINO REAL",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943012302",
            "telephone_number": "650-853-2916"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 E. El Camino Real",
            "address_purpose": "LOCATION",
            "city": "Mountain View",
            "state": "CA",
            "postal_code": "940402833",
            "country_code": "US",
            "telephone_number": "650-934-7090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIN",
        "first_name": "ELIZABETH",
        "middle_name": "CRISOSTOMO",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-24",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "794542",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "20645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.