Lauren Kelly Crostic, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA53720 Issued in CA

Practice address

16465 Sierra Lakes Pkwy
300
Fontana, CA 92336-1242

Phone

(909) 429-2864

NPI assigned

May 27, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Cucamonga Valley Medical Group, Inc.

  • Family Medicine Physician
  • Fontana, CA
  • NPI 1497783229
  Medicare reassignment

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

{
    "created_epoch": "1464307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542153600000",
    "number": "1215385448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16465 SIERRA LAKES PKWY",
            "address_2": "300",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361242",
            "telephone_number": "909-429-2864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16465 SIERRA LAKES PKWY",
            "address_2": "300",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361242",
            "telephone_number": "909-429-2864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSTIC",
        "first_name": "LAUREN",
        "middle_name": "KELLY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-27",
        "last_updated": "2018-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA53720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Lynn Crawford, PHARM.D.
• Jeron Crawford
• Creative Smiles Dental
• Philip Cristantiello
• Cassandra Renee Crook
• Sandra C. Crowder, MD
• Susan J Crowe, NP
• Cruisecare Transport LLC
• Pamela Cruz-Ramirez
• Aryana Natalie Cruz

• Physician Assistant in Fontana, CA
• Providers in Fontana, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.