Bryan K Criswell, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

261168690 Issued in NC

Practice address

14835 Ballantyne Village Way Ste 210
Charlotte, NC 28277

Phone

(704) 424-5050

NPI assigned

Aug 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Plastic and Reconstructive Surgery

Education

University of New Mexico School of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Criswell and Criswell, P.a.Group PAC ID 3476622572, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Criswell & Criswell, P.a.

  • Plastic Surgery Physician
  • Charlotte, NC
  • NPI 1710165915
  Medicare reassignment Care Compare group NPD Authorized official
• Holy Cross Hospital

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1952373557
  NPD (past)

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565913600000",
    "number": "1487667267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14835 BALLANTYNE VILLAGE WAY STE 210",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282774316",
            "telephone_number": "704-424-5050",
            "fax_number": "773-884-8065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14835 BALLANTYNE VILLAGE WAY STE 210",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28277",
            "telephone_number": "704-424-5050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2701 W 68th St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606291813",
            "country_code": "US",
            "telephone_number": "773-884-7920",
            "fax_number": "773-884-8065",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRISWELL",
        "first_name": "BRYAN",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2019-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036115698",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "IL",
            "license": "036115698",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "261168690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ria Crissinger, LCMHCA
• Jon Anthony Cristino, CRNA
• Mikayla Mary Cristino, PA
• Elizabeth Louise Cristy
• Criswell & Criswell, P.a.
• Kara Kane Criswell, M.D.
• Sean Randall Crites, MD
• Maleah J Crocker
• Latoya Crockett
• Ebony Crockton

• Surgery Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.