Individual provider Active NPI

Jeremy D. Cristol, MD

  • Family Medicine Physician
  • Newark, DE
National Provider Identifier
1225458748
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C1-0012245 Issued in DE
Practice address
4735 Ogletown Stanton Rd Ste 1250
Newark, DE 19713-2076
Phone
(302) 623-0200
Fax
(302) 623-0267
NPI assigned
Apr 23, 2014
Last updated
Jan 5, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C1-0012245 DE Primary

Addresses

Primary practice location

4735 Ogletown Stanton Rd Ste 1250
Newark, DE 19713-2076

Mailing address

200 Hygeia Drive, Suite 2300
CCHS Physician Contracting
Newark, DE 19713-2049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20170829000886 DE Practitioner - Family Practice 4789801713 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Temple University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Christiana Care Health Services IncGroup PAC ID 9739097569, shared by 25 NPIs, 1,480 clinicians

Practice addresses (Care Compare)

1401 Foulk Rd
Suite 100B
Wilmington, DE 19803-2764
Phone (302) 477-3300

501 W 14TH St
Wilmington, DE 19801-1013
Phone (302) 320-4410

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C1-0012245DEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services, Inc Family Medicine CurrentSince Jul 14, 2017 Accepting new patients
Christiana Care Health Services Inc Family Medicine CurrentSince Sep 6, 2017 Accepting new patients
Christiana Care Health Services, Inc Current Accepting new patients
Christiana Care Health Services Inc CurrentSince Jul 14, 2017 Accepting new patients

Locations

726 Yorklyn Rd
Ste 100
Hockessin, DE 19707
Phone (302) 234-5770

200 Hygeia Dr
Ste 2300
Newark, DE 19713
Phone (302) 623-7362

4735 Ogletown Stanton Rd
Ste 1250
Newark, DE 19713
Phone (302) 623-0200

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

501 W 14th St
Wilmington, DE 19801
Phone (302) 320-4411

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1398211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1225458748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HYGEIA DRIVE, SUITE 2300",
            "address_2": "CCHS PHYSICIAN CONTRACTING",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4735 OGLETOWN STANTON RD STE 1250",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132076",
            "telephone_number": "302-623-0200",
            "fax_number": "302-623-0267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISTOL",
        "first_name": "JEREMY",
        "middle_name": "D.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-23",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DE",
            "license": "C1-0012245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.