Individual provider Active NPI

Crystal Mumford, PA

  • Physician Assistant
  • Kalamazoo, MI
National Provider Identifier
1619133907
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1535 Gull Rd Ste 200
Kalamazoo, MI 49048-1638
Phone
(269) 388-6350
Fax
(269) 388-4738
NPI assigned
Aug 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MI Primary

Addresses

Primary practice location

1535 Gull Rd Ste 200
Kalamazoo, MI 49048-1638

Mailing address

1535 Gull Rd Ste 200
Kalamazoo, MI 49048-1638
Phone (269) 388-6350

Other practice location 1

125 S Kalamazoo Mall
Suite 204
Kalamazoo, MI 49007-4832
Phone (269) 343-3900 ext. 228

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.bronsonhg.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20081203000701 MI Practitioner - Physician Assistant 8527129915 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bronson Battle Creek HospitalGroup PAC ID 0547173478, 187 clinicians
Bronson Methodist HospitalGroup PAC ID 0244148633, 721 clinicians

Practice addresses (Care Compare)

300 N Ave
Battle Creek, MI 49017-3307

300 N Ave Outpatient Ctr 2ND FL
Bronson Neuroscience Center
Battle Creek, MI 49017-3307
Phone (269) 245-5862

601 John St
Kalamazoo, MI 49007-5341

601 John St
Kalamazoo, MI 49007-5377

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.43 of 100Reported as group
Quality
75.38
Promoting interoperability
100
Improvement activities
40
Cost
79.38

Merit-based Incentive Payment System (MIPS)

Final score
87.91 of 100Reported as group
Quality
83.03
Promoting interoperability
100
Improvement activities
40
Cost
76.65

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Services of Southwestern Michigan, PC Current Accepting new patients
Ascension Medical Group Promed CurrentSince Nov 30, 2015 Accepting new patients
Bronson Methodist Hospital Physician Assistant CurrentSince Oct 26, 2020 Accepting new patients
Diagnostic Pathology Services of Southwest Michigan PC Current Accepting new patients
Patholgy Services of Kalamazoo, PC Current Accepting new patients
Promed Healthcare CurrentSince Nov 30, 2015 Accepting new patients
Bronson Battle Creek Hospital Physician Assistant CurrentSince Oct 26, 2020 Accepting new patients

Locations

555 Linn St
Allegan, MI 49010
Phone (269) 673-8424

300 North Ave
Fl 2
Battle Creek, MI 49017
Phone (269) 245-5862

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

601 John St
Ste M-460
Kalamazoo, MI 49007
Phone (269) 341-7333

1541 Gull Rd
Ste 200
Kalamazoo, MI 49048
Phone (269) 343-1264

125 S Kalamazoo Mall
Ste 204
Kalamazoo, MI 49007
Phone (269) 343-3900

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

1535 Gull Rd
Ste 200
Kalamazoo, MI 49048
Phone (269) 388-6350

408 Hazen St
Paw Paw, MI 49079
Phone (269) 341-8481

7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405

Interoperability endpoints

  • Direct secure messaging: direct@direct.bronsonhg.org

Organizations & group practices 7

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.

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": "1217980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1619133907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1535 GULL RD STE 200",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481638",
            "telephone_number": "269-388-6350",
            "fax_number": "269-388-4738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 GULL RD STE 200",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481638",
            "telephone_number": "269-388-6350",
            "fax_number": "269-388-4738"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 S Kalamazoo Mall",
            "address_2": "SUITE 204",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490074832",
            "country_code": "US",
            "telephone_number": "269-343-3900 x228",
            "fax_number": "269-343-5640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUMFORD",
        "first_name": "CRYSTAL",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-06",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.