Individual provider Active NPI

Crystal Riley, PA-C

  • Physician Assistant
  • Westminster, MD
National Provider Identifier
1578957585
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0005716 Issued in MD
Practice address
193 Stoner Ave Ste 300
Westminster, MD 21157-5588
Phone
(410) 871-2204
Fax
(410) 871-2207
NPI assigned
Mar 27, 2015
Last updated
Feb 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-05657 NC
Physician Assistant 363A00000X C0005716 MD Primary

Addresses

Primary practice location

193 Stoner Ave Ste 300
Westminster, MD 21157-5588

Mailing address

193 Stoner Ave Ste 300
Westminster, MD 21157-5588
Phone (410) 871-2204

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20170118000352 MD Practitioner - Physician Assistant 1557672284 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carroll Health Group LLCGroup PAC ID 3870627029, 68 clinicians

Practice addresses (Care Compare)

193 Stoner Ave
Suite 220
Westminster, MD 21157-6881
Phone (410) 876-3380

193 Stoner Ave
Suite 300
Westminster, MD 21157-5588
Phone (410) 871-9032

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.16 of 100Reported as group
Quality
75.05
Promoting interoperability
100
Improvement activities
40
Cost
68.82

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0005716MDMDPhysician Assistant
0010-05657NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carroll Health Group, LLC CurrentSince Nov 29, 2016 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

504 E Ridgeville Blvd
Ste 110
Mount Airy, MD 21771
Phone (301) 829-5906

193 Stoner Ave
Ste 220
Westminster, MD 21157
Phone (410) 871-2204

193 Stoner Ave
Ste 300
Westminster, MD 21157
Phone (410) 848-4664

Organizations & group practices 2

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": "1427414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1578957585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "193 STONER AVE STE 300",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211575588",
            "telephone_number": "410-871-2204",
            "fax_number": "410-871-2207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "193 STONER AVE STE 300",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211575588",
            "telephone_number": "410-871-2204",
            "fax_number": "410-871-2207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "CRYSTAL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-27",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-05657",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0005716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, MD

Sources for this page

Verify at the official NPI Registry.