Active NPI
Crystal S Baca, AU.D.
- Audiologist
- Albuquerque, NM
National Provider Identifier
1437380193
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 4682
- Practice address
- 5005 Prospect Ave NE
Ste C
Albuquerque, NM 87110-4275 - Phone
- (505) 247-4466
- Fax
- (505) 247-4472
- NPI assigned
- Jul 29, 2009
- Last updated
- Jun 16, 2015
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | 4682 | NM | Primary |
Addresses
Primary practice location
5005 Prospect Ave NE
Ste C
Albuquerque, NM 87110-4275
Mailing address
5005 Prospect Ave NE
Ste C
Albuquerque, NM 87110-4275
Phone (505) 247-4466
Other names 1
- Dr. Crystal S Carnell
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4682 | NM | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ear Associates PC | Past | Accepting new patients | |
| Better Hearing Audiology, LLC | Audiologist | Past | Accepting new patients |
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.
-
dba Better Hearing Audiology
- Audiologist
- Albuquerque, NM
- NPI 1861140931
-
- Otolaryngology Physician
- Albuq, NM
- NPI 1699840272
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434412800000",
"number": "1437380193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5005 PROSPECT AVE NE",
"address_2": "STE C",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871104275",
"telephone_number": "505-247-4466",
"fax_number": "505-247-4472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5005 PROSPECT AVE NE",
"address_2": "STE C",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871104275",
"telephone_number": "505-247-4466",
"fax_number": "505-247-4472"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BACA",
"first_name": "CRYSTAL",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "AU.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-29",
"last_updated": "2015-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "NM",
"license": "4682",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CRYSTAL",
"last_name": "CARNELL",
"middle_name": "S",
"prefix": "DR.",
"credential": "AU.D.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.