Individual provider Active NPI

Julie D Crispin, M.D.

  • Anesthesiology Physician
  • Port St Lucie, FL
National Provider Identifier
1598719908
Registry record updated Aug 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME62172 Issued in FL
Practice address
1800 SE Tiffany Ave
Port St Lucie, FL 34952-7521
Phone
(772) 398-3770
NPI assigned
May 20, 2006
Last updated
Aug 8, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X ME62172 FL Primary

Addresses

Primary practice location

1800 SE Tiffany Ave
Port St Lucie, FL 34952-7521

Mailing address

30 E High Point Rd
Stuart, FL 34996-7002
Phone (772) 219-2502

Other identifiers 1

IdentifierTypeStateIssuer
378824500MedicaidFL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081028000197 FL Practitioner - Anesthesiology 0345316089 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME62172FLMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sheridan Healthcorp Inc Anesthesiology CurrentSince Feb 1, 2023 Accepting new patients
Sheridan Healthcorp, Inc. Anesthesiology CurrentSince Feb 1, 2023 Accepting new patients
Sheridan Healthcorp Inc Anesthesiology Current Accepting new patients
St Lucie Anesthesia Associates LLC Anesthesiology CurrentSince Jul 1, 2008 Accepting new patients
St. Lucie Anesthesia Associates, LLC Anesthesiology CurrentSince Jul 1, 2008 Accepting new patients
Atlantic Coast Anesthesia Associates Anesthesiology Past Accepting new patients

Locations

501 Glades Rd
Boca Raton, FL 33432
Phone (561) 362-4400

3995 NW Goldenrod Rd
Jensen Beach, FL 34957
Phone (772) 497-0020

2275 N Central Ave
Kissimmee, FL 34741
Phone (407) 570-0573

1796 US Highway 441 N
Okeechobee, FL 34972
Phone (863) 467-5222

1800 SE Tiffany Ave
Port St Lucie, FL 34952
Phone (772) 398-1969

1613 NW 136th Ave
Ste 200
Sunrise, FL 33323
Phone (954) 838-2502

3602 Kyoto Gardens Dr
West Palm Beach, FL 33410
Phone (561) 799-2288

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249689600000",
    "number": "1598719908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 E HIGH POINT RD",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349967002",
            "telephone_number": "772-219-2502",
            "fax_number": "772-220-2687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 SE TIFFANY AVE",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527521",
            "telephone_number": "772-398-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISPIN",
        "first_name": "JULIE",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2009-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME62172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "378824500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.