Active NPI
Crispin Quismundo
- Physical Therapist
- Sunrise, FL
National Provider Identifier
1336686047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 12471 NW 15TH PL
Apt 16308
Sunrise, FL 33323-5230 - Phone
- (954) 512-7475
- NPI assigned
- Jan 20, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
12471 NW 15TH PL
Apt 16308
Sunrise, FL 33323-5230
Mailing address
12471 NW 15TH PL
Apt 16308
Sunrise, FL 33323-5230
Phone (954) 512-7475
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| W2328 08140 | Other | AETNA |
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484870400000",
"number": "1336686047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12471 NW 15TH PL",
"address_2": "APT 16308",
"city": "SUNRISE",
"state": "FL",
"postal_code": "333235230",
"telephone_number": "954-512-7475"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12471 NW 15TH PL",
"address_2": "APT 16308",
"city": "SUNRISE",
"state": "FL",
"postal_code": "333235230",
"telephone_number": "954-512-7475"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUISMUNDO",
"first_name": "CRISPIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-01-20",
"last_updated": "2017-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "W2328 08140",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Sunrise, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.