Individual provider Active NPI

Crystal Lee Gunn, PA

  • Physician Assistant
  • Sayre, PA
National Provider Identifier
1386848810
Registry record updated Apr 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA051691 Issued in PA
Practice address
1 Guthrie SQ
Sayre, PA 18840-1625
Phone
(570) 887-2300
NPI assigned
Jun 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA051691 PA Primary

Addresses

Primary practice location

1 Guthrie SQ
Sayre, PA 18840-1625

Mailing address

3 E Hill Church Rd
Addison, NY 14801-9648
Phone (724) 762-3697

Other identifiers 1

IdentifierTypeStateIssuer
03319775MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20081018000057 PA Practitioner - Physician Assistant 5294893319 Reassigns benefits to 1 organization
I20180219001271 FL Practitioner - Physician Assistant 5294893319 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA051691PAMDPhysician Assistant

Practice roles (3 of 5)

OrganizationSpecialtyStatusNew patients
Guthrie Medical Group, P.C. CurrentSince Oct 1, 2012 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Oct 1, 2012 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

130 Center Way
Corning, NY 14830
Phone (607) 936-9971

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Florida Surgical Associates LLC 52 clinicians
Intensive Care Consortium Inc 485 clinicians

Practice addresses (Care Compare)

1121 NW 64TH Ter
Gainesville, FL 32605-4256

2001 Kingsley Ave
Orange Park, FL 32073-5148
Phone (904) 276-8500

2626 Capital Medical Blvd
Tallahassee, FL 32308-4402
Phone (561) 997-0831

6500 Newberry Rd
North Florida Regional Medical Center
Gainesville, FL 32605-4309
Phone (352) 333-2013

6500 W Newberry Rd
Gainesville, FL 32605-4309
Phone (561) 997-0821

Hospital & facility affiliations

  • HCA Florida North Florida Hospital Hospital, Gainesville, FL, CCN 100204
  • HCA Florida Capital Hospital Hospital, Tallahassee, FL, CCN 100254

Merit-based Incentive Payment System (MIPS)

Final score
89.66 of 100Reported as group
Quality
81.9
Promoting interoperability
99
Improvement activities
40
Cost
75.61

NPI Registry JSON

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493164800000",
    "number": "1386848810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 E HILL CHURCH RD",
            "city": "ADDISON",
            "state": "NY",
            "postal_code": "148019648",
            "telephone_number": "724-762-3697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUTHRIE SQ",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401625",
            "telephone_number": "570-887-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNN",
        "first_name": "CRYSTAL",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-11",
        "last_updated": "2017-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA051691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03319775",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sayre, PA

Sources for this page

Verify at the official NPI Registry.