Individual provider Active NPI

Kristina Crump, FNP-BC

  • Family Nurse Practitioner
  • Palmdale, CA
National Provider Identifier
1558006288
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95020107 Issued in CA
Practice address
1120 W Avenue M4
Palmdale, CA 93551-1432
Phone
(661) 480-2377
Fax
(661) 480-2378
NPI assigned
Apr 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 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 95020107 CA Primary

Addresses

Primary practice location

1120 W Avenue M4
Palmdale, CA 93551-1432

Mailing address

40020 Tesoro LN
Palmdale, CA 93551-3575
Phone (661) 965-4101

Other practice location 1

320 E Palmdale Blvd
Palmdale, CA 93550-4598
Phone (661) 729-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20220609001439 CA Practitioner - Nurse Practitioner 6002294634 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dr Kamran Parsa IncGroup PAC ID 4880909308, 22 clinicians

Practice addresses (Care Compare)

1120 W Ave
M4
Palmdale, CA 93551-1432
Phone 6614802377207

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Kamran Parsa Inc CurrentSince May 16, 2022 Accepting new patients

Locations

1120 W Avenue M4
Palmdale, CA 93551
Phone (661) 480-2377

38420 5th St W
Ste E
Palmdale, CA 93551
Phone (661) 480-2377

13540 Ventura Blvd
Sherman Oaks, CA 91423
Phone (818) 990-0267

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1651017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1558006288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40020 TESORO LN",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935513575",
            "telephone_number": "661-965-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 W AVENUE M4",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935511432",
            "telephone_number": "661-480-2377",
            "fax_number": "661-480-2378"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 E Palmdale Blvd",
            "address_purpose": "LOCATION",
            "city": "Palmdale",
            "state": "CA",
            "postal_code": "935504598",
            "country_code": "US",
            "telephone_number": "661-729-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUMP",
        "first_name": "KRISTINA",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-27",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95020107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

Verify at the official NPI Registry.