Crystal Ann Birdsong, NP
Individual provider Active NPI Nurse Practitioner · Kirkland, WA
NPI 1457540189 · NPPES record last updated Oct 3, 2024
Key facts
- NPI
- 1457540189
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- AP61577387 (WA)
- Practice address
- 11417 124TH Ave NE Ste 100
Kirkland, WA 98033-4677 - Phone
- (800) 640-3451
- NPI assigned
- Oct 18, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 8
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Plaid Eagle Medical PLLC
Practice addresses (Care Compare)
11417 124TH Ave NE
Suite 100
Kirkland, WA 98033-4677
Phone (800) 640-3451
25195 SW Pkwy Ave
Suite 210
Wilsonville, OR 97070-9689
Phone (800) 640-3451
3035 S Parker Rd
Suite 554
Aurora, CO 80014-2936
Phone (800) 640-3451
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in CO, OR, WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140307000595 | CO | Practitioner - Nurse Practitioner | 2365672581 |
Reassigns benefits to 1 organization Practice locations: Alamosa, CO; La Jara, CO; Monte Vista, CO |
| I20241009003350 | OR | Practitioner - Nurse Practitioner | 2365672581 | Reassigns benefits to 1 organization |
| I20241015000669 | WA | Practitioner - Nurse Practitioner | 2365672581 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Plaid Eagle Medical PLLC | Current |
Accepting new patients | |
| Geriatric and Hospice Medical Services | Past | Accepting new patients | |
| Geriatric Associates of America-Texas, PLLC | Adult Health | Past | Accepting new patients |
| Lutheran Hospital Association of the San Luis Valley | Nurse Practitioner | Past |
Accepting new patients |
| Monte Vista Investors, LLC | Past | Accepting new patients | |
| Life Care Physician Services, LLC | Past | Accepting new patients | |
| Alamosa Foot and Nail Care Medical Services | Adult Health | Past |
Accepting new patients |
| Geriatric Associates of America, P.a. | Adult Health | Past |
Accepting new patients |
Locations
13741 E Rice Pl
Ste 101
Aurora, CO 80015
Phone (801) 888-1140
3035 S Parker Rd
Ste 554
Aurora, CO 80014
Phone (303) 338-9111
25195 SW Parkway Ave
Ste 210
Wilsonville, OR 97070
Phone 8006403451 ext. 97070
11417 124th Ave NE
Ste 100
Kirkland, WA 98033
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 10027979 | OR | |
| Nurse Practitioner | 363L00000X | AP61577387 | WA | Yes |
Addresses
Primary practice location
11417 124TH Ave NE Ste 100
Kirkland, WA 98033-4677
Mailing address
PO Box 1200
Pleasant Grove, UT 84062-1200
Phone (800) 640-3451
Other practice location 1
25195 SW Parkway Ave Ste 210
Wilsonville, OR 97070-9689
Phone (800) 640-3451
Other names
- Ms. Crystal Ann Birdsong
Other providers in Kirkland, WA
- Timothy W Billings
- Talia Bills
- Amy Binns
- Biofourmis Care FL PLLC
- Wendy Bircher
- Carin Birka
- Nita Ellen Bishop
- D'Anne Bissell
- Dinora Bissenova
- Stephen Jon Bittner
All providers in Kirkland, WA · Nurse Practitioner in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 3, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.