Individual provider Active NPI

Krystina Ashley Baez, LPN

  • Licensed Practical Nurse
  • New York, NY
National Provider Identifier
1619447489
Registry record updated Dec 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
333675-1 Issued in NY
Practice address
190 Mercer St # 646
New York, NY 10012-1502
Phone
(212) 677-3400
Fax
(646) 532-2811
NPI assigned
Dec 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 333675-1 NY Primary

Addresses

Primary practice location

190 Mercer St # 646
New York, NY 10012-1502

Mailing address

70 Bruckner Blvd Apt 9C
Bronx, NY 10454-4540
Phone (718) 350-6264

Other identifiers 1

IdentifierTypeStateIssuer
13-5562204MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
333675-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1543968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543968000000",
    "number": "1619447489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 BRUCKNER BLVD APT 9C",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104544540",
            "telephone_number": "718-350-6264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 MERCER ST # 646",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100121502",
            "telephone_number": "212-677-3400",
            "fax_number": "646-532-2811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAEZ",
        "first_name": "KRYSTINA",
        "middle_name": "ASHLEY",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-05",
        "last_updated": "2018-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "333675-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13-5562204",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.