Individual provider Active NPI

Christopher Robin Cromwell, MD

  • Plastic and Reconstructive Surgery Physician
  • Port Saint Lucie, FL
National Provider Identifier
1629073382
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
ME106293 Issued in FL
Practice address
293 NW Peacock Blvd Ste 201
Port Saint Lucie, FL 34986-2222
Phone
(772) 204-8870
Fax
(772) 204-8873
NPI assigned
Jun 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 106293 FL
Plastic and Reconstructive Surgery Physician 2086S0122X 200401193 NC
Plastic and Reconstructive Surgery Physician 2086S0122X ME106293 FL Primary

Addresses

Primary practice location

293 NW Peacock Blvd Ste 201
Port Saint Lucie, FL 34986-2222

Mailing address

293 NW Peacock Blvd Ste 201
Port Saint Lucie, FL 34986-2222
Phone (772) 204-8870

Other practice location 1

537 NW Lake Whitney Pl
suite 101
Port Saint Lucie, FL 34986-1620
Phone (772) 204-8870

Other identifiers 2

IdentifierTypeStateIssuer
138JWOtherBCBS
89138JWMedicaidNC

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
I20100512000363 FL Practitioner - Plastic and Reconstructive Surgery 2163411216 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Temple University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aqua Dermatology of Florida, PAGroup PAC ID 1153390414, 184 clinicians

Practice addresses (Care Compare)

1015 Crosspointe Dr
Naples, FL 34110-0949
Phone (239) 596-9075

1400 SE Goldtree Dr
Suite 107
Port St Lucie, FL 34952-7582
Phone (772) 217-6551

2601 S Kanner Hwy
Stuart, FL 34994-4622
Phone (772) 217-6829

264 NW Peacock Blvd
Port St Lucie, FL 34986-2272
Phone (772) 217-6786

7765 144TH St
Unit 1
Sebastian, FL 32958-3206
Phone (772) 217-6621

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision115
Removal of tissue1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy26

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
106293FLMDPlastic Surgery Physician
200401193NCMDPlastic and Reconstructive Surgery Physician
230784NYMDPersonal Care Attendant

Practice roles

OrganizationSpecialtyStatusNew patients
Naples Center for Dermatology & Riverchase Dermatology CurrentSince Jan 1, 2022 Accepting new patients
Aqua Dermatology of Florida, PA CurrentSince Jan 1, 2022 Accepting new patients
Water'S Edge Dermatology, LLC CurrentSince Jun 2, 2019 Accepting new patients
Water'S Edge Dermatology, LLC CurrentSince Jun 2, 2019 Accepting new patients
Broward Neurosurgeons LLC PastSince Apr 5, 2010 Accepting new patients
Specialists in Plastic Surgery PA PastSince Nov 27, 2000 Accepting new patients
Specialists in Plastic Surgery Past Accepting new patients

Locations

5101 Okeechobee Rd
Fort Pierce, FL 34947
Phone (772) 595-5995

6250 Lantana Rd
Ste 9
Lake Worth, FL 33463
Phone (561) 578-8100

3659 S Miami Ave
Ste 6008
Miami, FL 33133
Phone (305) 854-5432

1015 Crosspointe Dr
Naples, FL 34110
Phone (239) 596-9075

14840 Tamiami Trl
North Port, FL 34287
Phone (941) 564-1542

301 NE 19th Dr
Okeechobee, FL 34972
Phone (863) 357-0039

2845 Pga Blvd
Palm Beach Gardens, FL 33410
Phone (561) 693-0540

600 Village Square Xing
Palm Beach Gardens, FL 33410
Phone (561) 693-0540

7765 144th St
Unit 1
Sebastian, FL 32958
Phone (772) 217-6621

264 NW Peacock Blvd
Ste 101
St Lucie West, FL 34986
Phone (727) 800-5599

264 NW Peacock Blvd
Ste 201
St Lucie West, FL 34986
Phone (772) 323-2321

264 NW Peacock Blvd
St Lucie West, FL 34986
Phone (772) 208-8800

3745 11th Cir
Ste 107
Vero Beach, FL 32960
Phone (772) 562-2330

805 37th Pl
Vero Beach, FL 32960
Phone (772) 257-7373

38162 Medical Center Ave
Zephyrhills, FL 33540
Phone (813) 782-2165

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: ccromwell@aquadermatology.emadirect.md

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": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1629073382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "293 NW PEACOCK BLVD STE 201",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349862222",
            "telephone_number": "772-204-8870",
            "fax_number": "772-204-8873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "293 NW PEACOCK BLVD STE 201",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349862222",
            "telephone_number": "772-204-8870",
            "fax_number": "772-204-8873"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "537 NW Lake Whitney Pl",
            "address_2": "suite 101",
            "address_purpose": "LOCATION",
            "city": "Port Saint Lucie",
            "state": "FL",
            "postal_code": "349861620",
            "country_code": "US",
            "telephone_number": "772-204-8870",
            "fax_number": "772-204-8873",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CROMWELL",
        "first_name": "CHRISTOPHER",
        "middle_name": "ROBIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "106293",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NC",
            "license": "200401193",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "FL",
            "license": "ME106293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "138JW",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89138JW",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

Verify at the official NPI Registry.