Individual provider Active NPI

Lizel Anne Bernabe Crisostomo

  • Certified Registered Nurse Anesthetist
  • Baltimore, MD
National Provider Identifier
1619692134
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R215493 Issued in MD
Practice address
525 N Wolfe St
Baltimore, MD 21205-2110
Phone
(410) 955-4766
NPI assigned
Oct 6, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R215493 MD
Certified Registered Nurse Anesthetist 367500000X R215493 MD Primary

Addresses

Primary practice location

525 N Wolfe St
Baltimore, MD 21205-2110

Mailing address

808 Tipton Rd
Middle River, MD 21220-3780

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250820000072 MD Practitioner - Certified Registered Nurse Anesthetist (Crna) 0244739803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

9000 Franklin Square Dr
Baltimore, MD 21237-3901
Phone (443) 777-7000

Hospital & facility affiliations

  • Medstar Franklin Square Medical Center Hospital, Rosedale, MD, CCN 210015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R215493MDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Aug 1, 2025 Accepting new patients

Locations

3007 Tilden St NW
Ste 5N
Washington, DC 20008

1406 Crain Hwy S
Ste 106
Glen Burnie, MD 21061
Phone (410) 768-6440

9000 Franklin Square Dr
Rosedale, MD 21237
Phone (410) 682-7000

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.

Hospital & facility affiliations 1

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": "1665014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1619692134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 TIPTON RD",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212203780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 N WOLFE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212052110",
            "telephone_number": "410-955-4766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISOSTOMO",
        "first_name": "LIZEL ANNE",
        "middle_name": "BERNABE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-06",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R215493",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": "R215493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.