Individual provider Active NPI

Crystal Trujillo

  • Anatomic Pathology & Clinical Pathology Physician
  • Metairie, LA
National Provider Identifier
1679981658
Registry record updated Jul 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
MD207158 Issued in LA
Practice address
4648 I-10 Service Road
Metairie, LA 70001
Phone
(505) 883-4800
NPI assigned
Jul 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD207158 LA Primary

Addresses

Primary practice location

4648 I-10 Service Road
Metairie, LA 70001

Mailing address

15790 Paul Vega Dr
Laboratory Services
Hammond, LA 70403-1434
Phone (985) 230-6165

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220427002156 TX Practitioner - Pathology 4082834890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gulf Coast Pathology Program PLLCGroup PAC ID 3476956194, 38 clinicians

Practice addresses (Care Compare)

4000 Spencer Hwy
Pasadena, TX 77504-1202
Phone (713) 359-1600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD207158LAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Westwater Diagnostics PLLC Anatomic Pathology & Clinical Pathology Current Accepting new patients
Gulf Coast Pathology Program PLLC Anatomic Pathology & Clinical Pathology CurrentSince Apr 25, 2022 Accepting new patients
Cardiovascular Care Providers, Inc. Past Accepting new patients
Gulf Coast Pathology Program PLLC Anatomic Pathology & Clinical Pathology Past Accepting new patients

Locations

504 Medical Center Blvd
Conroe, TX 77304
Phone (936) 539-1111

21214 Northwest Fwy
Cypress, TX 77429
Phone (832) 912-3500

12141 Richmond Ave
Houston, TX 77082
Phone (281) 558-3444

4000 Spencer Hwy
Pasadena, TX 77504
Phone (713) 359-1000

11100 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 770-7000

6801 Emmett F Lowry Expy
Texas City, TX 77591
Phone (409) 938-5095

500 W Medical Center Blvd
Webster, TX 77598
Phone (713) 447-4650

Organizations & group practices 4

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": "1406073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406073600000",
    "number": "1679981658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15790 PAUL VEGA DR",
            "address_2": "LABORATORY SERVICES",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704031434",
            "telephone_number": "985-230-6165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4648 I-10 SERVICE ROAD",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "70001",
            "telephone_number": "505-883-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUJILLO",
        "first_name": "CRYSTAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-23",
        "last_updated": "2014-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "LA",
            "license": "MD207158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.