Kristal Jaime, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95023267 Issued in CA

Practice address

2332 Victoria CT
Imperial, CA 92251-8800

Phone

(760) 427-4733

NPI assigned

Apr 20, 2023

Last updated

Apr 20, 2023By the provider in NPPES

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sasha Salloum MD Inc a Professional Medical CorporationGroup PAC ID 5991012130, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Sasha Salloum MD Inc a Professional Medical Corporation

  dba SS Vascular

  • Vascular Surgery Physician
  • Chula Vista, CA
  • NPI 1578949889
  Medicare reassignment Care Compare group NPD
• Vascular Associates of San Diego

  • Vascular Surgery Physician
  • La Mesa, CA
  • NPI 1104975713
  NPD (past)

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

{
    "created_epoch": "1681948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1255028205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2332 VICTORIA CT",
            "city": "IMPERIAL",
            "state": "CA",
            "postal_code": "922518800",
            "telephone_number": "760-427-4733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2332 VICTORIA CT",
            "city": "IMPERIAL",
            "state": "CA",
            "postal_code": "922518800",
            "telephone_number": "760-427-4733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIME",
        "first_name": "KRISTAL",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-20",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95023267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Imperial Usd
• Imperial Valley Family Care Medical Group
• Imperial Valley Family Care Medical Group Apc
• Imperial Valley Family Care Medical Group, Apc
• Imperial Valley Sleep Disorders
• Matthew John Jaime, RD
• Samantha Jimenez
• Charisma Shauntae Johnson, LVN
• Crystal Johnson
• Byron Justus, DMD

• Family Nurse Practitioner in Imperial, CA
• Providers in Imperial, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.