Individual provider Active NPI

Teri Janeane Cristaldi, D.C.

  • Chiropractor
  • Lady Lake, FL
National Provider Identifier
1356713564
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH12185 Issued in FL
Practice address
628 Cedar LN
Lady Lake, FL 32159-3211
Phone
(406) 396-3502
NPI assigned
Oct 27, 2015
Last updated
May 24, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3970 MT
Chiropractor 111N00000X CH12185 FL Primary

Addresses

Primary practice location

628 Cedar LN
Lady Lake, FL 32159-3211

Mailing address

628 Cedar LN
Lady Lake, FL 32159-3211
Phone (406) 396-3502

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170718002432 FL Practitioner - Chiropractic 5294035192 Reassigns benefits to 1 organization
Practice locations: Lady Lake, FL

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

628 Cedar LN
Lady Lake, FL 32159-3211
Phone (406) 396-3502

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH12185FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Bender Chiropractic Center PA Chiropractor CurrentSince May 13, 2017 Accepting new patients
Clark D Lundgren DC LLC Chiropractor PastSince Jan 5, 2019 Accepting new patients
Yoder Chiropractic Inc Chiropractor PastSince Oct 2, 2008 Accepting new patients

Locations

321 Indian Rocks Rd N
Ste C
Belleair Bluffs, FL 33770
Phone (727) 559-7881

Organizations & group practices 3

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": "1445904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1356713564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 CEDAR LN",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321593211",
            "telephone_number": "406-396-3502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 CEDAR LN",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321593211",
            "telephone_number": "406-396-3502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISTALDI",
        "first_name": "TERI",
        "middle_name": "JANEANE",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-27",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MT",
            "license": "3970",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH12185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lady Lake, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.