Individual provider Active NPI

Cristina Alyssa Sumilang, RN

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1316468077
Registry record updated Feb 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
342842 Issued in NY
Practice address
530 5TH Ave FL 10
New York, NY 10036-5114
Phone
(917) 261-4414
NPI assigned
Jul 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2024

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN2358189 MA
Family Nurse Practitioner 363LF0000X 1022069 TX
Family Nurse Practitioner 363LF0000X 342842 NY Primary
Family Nurse Practitioner 363LF0000X 209023382 IL
Registered Nurse 163W00000X 647328 NY
Registered Nurse 163W00000X 041509943 IL
Registered Nurse 163W00000X RN2358189 MA
Family Nurse Practitioner 363LF0000X 95020711 CA
Registered Nurse 163W00000X 95261646 CA

Addresses

Primary practice location

530 5TH Ave FL 10
New York, NY 10036-5114

Mailing address

1 Liberty PLZ Ste 301
New York, NY 10006-1404

Other practice location 1

1110 N Virgil Ave
Los Angeles, CA 90029-2016
Phone (917) 261-4414

Other practice location 2

823 Congress Ave Ste 300
Austin, TX 78701-2448
Phone (917) 261-4414

Other practice location 3

1 Post Office Sq
Boston, MA 02109-2106
Phone (917) 261-4414

Other practice location 4

131 S Dearborn St Ste 1025
Chicago, IL 60603-5517
Phone (917) 261-4414

Other practice location 5

755 Main Street
24th Floor
Hartford, CT 06103
Phone (917) 261-4414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95261646CAMDRegistered Nurse
041509943ILMDRegistered Nurse
647328NYMDRegistered Nurse
95020711CAMDFamily Nurse Practitioner
209023382ILMDFamily Nurse Practitioner
RN2358189MAMDFamily Nurse Practitioner
1022069TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eden Health Medical of Il LTD Past Accepting new patients
Eden Health Medical of Texas, PA PastSince Sep 15, 2024 Accepting new patients

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": "1499040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708646400000",
    "number": "1316468077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LIBERTY PLZ STE 301",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100061404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 5TH AVE FL 10",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100365114",
            "telephone_number": "917-261-4414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1110 N Virgil Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900292016",
            "country_code": "US",
            "telephone_number": "917-261-4414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "823 Congress Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787012448",
            "country_code": "US",
            "telephone_number": "917-261-4414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Post Office Sq",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021092106",
            "country_code": "US",
            "telephone_number": "917-261-4414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "131 S Dearborn St Ste 1025",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606035517",
            "country_code": "US",
            "telephone_number": "917-261-4414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "755 Main Street",
            "address_2": "24th Floor",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "06103",
            "country_code": "US",
            "telephone_number": "917-261-4414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUMILANG",
        "first_name": "CRISTINA",
        "middle_name": "ALYSSA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-03",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2358189",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1022069",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "342842",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209023382",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "647328",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041509943",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2358189",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95020711",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95261646",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.