Kristine Grace Lee Dizon, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP95007409 Issued in CA

Practice address

110 N 4TH Ave
Covina, CA 91723-1825

Phone

(626) 859-6400

NPI assigned

Feb 19, 2018

Last updated

Feb 19, 2018By 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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Radhika Tulpule MD IncGroup PAC ID 2668480799, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Emanate Health Inter-Community Hospital Hospital, Covina, CA, CCN 050382
• Emanate Health Foothill Presbyterian Hospital Hospital, Glendora, CA, CCN 050597
• Casa Colina Hospital Hospital, Pomona, CA, CCN 050782

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Radhika Tulpule MD Inc.

  • Internal Medicine Physician
  • Covina, CA
  • NPI 1336196864
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Casa Colina Hospital and Centers for Healthcare

  • Rehabilitation Hospital
  • Pomona, CA
  • NPI 1821075870
  Care Compare affiliation
• Casa Colina Hospital and Centers for Healthcare

  • General Acute Care Hospital
  • Pomona, CA
  • NPI 1952777245
  Care Compare affiliation
• Emanate Health Foothill Presbyterian Hospital

  dba Foothill Presbyterian Hospital

  • General Acute Care Hospital
  • Glendora, CA
  • NPI 1992733513
  Care Compare affiliation
• Emanate Health Medical Center

  dba Citrus Valley Medical Center Queen Of the Valley Campus

  • General Acute Care Hospital
  • West Covina, CA
  • NPI 1063441293
  Care Compare affiliation
• Emanate Health Medical Center

  dba Emanate Health Inter-Community Hospital

  • Psychiatric Hospital Unit
  • Covina, CA
  • NPI 1215063151
  Care Compare affiliation
• Emanate Health Medical Center

  dba Citrus Valley Medical Center Inter-Community Campus

  • General Acute Care Hospital
  • Covina, CA
  • NPI 1982629440
  Care Compare affiliation

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

{
    "created_epoch": "1518998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518998400000",
    "number": "1336649060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14896 OAK LEAF DR",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928801049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N 4TH AVE",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231825",
            "telephone_number": "626-859-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIZON",
        "first_name": "KRISTINE GRACE",
        "middle_name": "LEE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-19",
        "last_updated": "2018-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95007409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Direct Outlook Psychological Services Inc.
• Alaysia Nicole Dixon
• Andrea Dixon
• Latasha Dixon, LMFT
• Monique Cheree Dixon, LMFT 142173
• Anna Djabourian
• Ben Djabourian
• Victoria Djabourian
• DM Laser and Derma Center
• Anthony DO, DPT

• Family Nurse Practitioner in Covina, CA
• Providers in Covina, 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 Feb 19, 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.
• 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.