Individual provider Active NPI

Michelle Koralewski, APRN, FNP-BC

  • Family Nurse Practitioner
  • Crestview, FL
National Provider Identifier
1487333613
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11027525 Issued in FL
Practice address
131 E Redstone Ave Ste 107
Crestview, FL 32539-5355
Phone
(850) 682-6320
NPI assigned
Jul 14, 2023
Last updated
Jul 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11027525 FL Primary

Addresses

Primary practice location

131 E Redstone Ave Ste 107
Crestview, FL 32539-5355

Mailing address

313 Egan Dr
Crestview, FL 32536-5426
Phone (850) 305-3583

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230821002657 FL Practitioner - Nurse Practitioner 3577925676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christopher MD and Associates PAGroup PAC ID 9133141328, 2 clinicians

Practice addresses (Care Compare)

131 E Redstone Ave
Suite 107
Crestview, FL 32539-5355
Phone (850) 682-6320

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11027525FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christopher MD & Associates, PA CurrentSince Jul 20, 2023 Accepting new patients

Locations

131 E Redstone Ave
Ste 107
Crestview, FL 32539
Phone (850) 682-4888

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DHBJAA

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1689292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1487333613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 EGAN DR",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325365426",
            "telephone_number": "850-305-3583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 E REDSTONE AVE STE 107",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325395355",
            "telephone_number": "850-682-6320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORALEWSKI",
        "first_name": "MICHELLE",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-14",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11027525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview, FL

Sources for this page

Verify at the official NPI Registry.