Individual provider Active NPI

Crystal Ann Acevedo Sierra, MD

  • Pediatrics Physician
  • Galveston, TX
National Provider Identifier
1336344902
Registry record updated Jun 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
N3310 Issued in TX
Practice address
301 University Blvd
Galveston, TX 77555-0519
Phone
(281) 482-5695
NPI assigned
Jun 15, 2007
Last updated
Jun 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X N3310 TX Primary

Addresses

Primary practice location

301 University Blvd
Galveston, TX 77555-0519

Mailing address

PO Box 650859 Dept 710
Dallas, TX 75265-0519
Phone (409) 772-0620

Other identifiers 1

IdentifierTypeStateIssuer
3851526898OtherMYUTMB 3851526898-COMMERCIAL NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20101006000412 TX Practitioner - Pediatric Medicine 8729270905 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Utmb Faculty Group Practice Pediatrics CurrentSince Jul 20, 2010 Accepting new patients
University of Texas Medical Branch at Galveston Past Accepting new patients

Locations

128 W Parkwood Ave
Friendswood, TX 77546
Phone (281) 482-5695

1715 S Friendswood Dr
Fl 4
Friendswood, TX 77546
Phone (281) 482-5695

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

Interoperability endpoints

  • Direct secure messaging: csierramd3138@direct.utmb.edu

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

NPI Registry JSON

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1336344902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650859 DEPT 710",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752650519",
            "telephone_number": "409-772-0620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775550519",
            "telephone_number": "281-482-5695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIERRA",
        "first_name": "CRYSTAL",
        "middle_name": "ANN ACEVEDO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-15",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "N3310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MYUTMB 3851526898-COMMERCIAL NUMBER",
            "identifier": "3851526898",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Galveston, TX

Sources for this page

Verify at the official NPI Registry.