Krystal Derico

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-20-149442 Issued in FL

Practice address

1849 Americana Blvd Apt 35K
Orlando, FL 32839-2225

Phone

(407) 432-7222

NPI assigned

Mar 15, 2022

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: krystalderico@claritybehaviorhealth.org

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.

• Different Skills 4 Different Mindsets Foundation Inc

  • Case Manager/Care Coordinator
  • Orlando, FL
  • NPI 1548025299
  NPD Authorized official
• Friends With Love Home Care Services LLC

  • Home Health Agency
  • Winter Garden, FL
  • NPI 1528851110
  NPD Authorized official

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

{
    "created_epoch": "1647302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1437807716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1849 AMERICANA BLVD APT 35K",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328392225",
            "telephone_number": "407-432-7222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1849 AMERICANA BLVD APT 35K",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328392225",
            "telephone_number": "407-432-7222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERICO",
        "first_name": "KRYSTAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-15",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-20-149442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109300300",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Krystalderico@claritybehaviorhealth.org",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1849 Americana Blvd Apt 35K",
            "city": "Orlando",
            "state": "FL",
            "country_code": "US",
            "postal_code": "328392225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gregory A Deramo, ARNP
• Derash Inc
• Narendra Dereddy, MD
• Jeffrey A. Deren, M.D.
• Herman Brace Deresma, APRN
• Triston Derieux
• Yonile Derivois, HOME HEALTH AIDE
• Dermalier Clinic LLC
• Dermatology and Skin Cancer Center
• Jamie Deron

• Behavior Technician in Orlando, FL
• Providers in Orlando, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.