Crystal L. Baker, FNP
Individual provider Active NPI Family Nurse Practitioner · Johnson City, NY
NPI 1699063198 · NPPES record last updated Feb 14, 2018
Key facts
- NPI
- 1699063198
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- F336899-1 (NY)
- Practice address
- 30 Harrison St Ste 355
Johnson City, NY 13790-2162 - Phone
- (607) 763-8102
- NPI assigned
- Jul 18, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120305000227 | NY | Practitioner - Nurse Practitioner | 2961661376 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F336899-1 | NY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| United Health Services Hospitals, Inc. | Current |
Accepting new patients |
Locations
33 Lewis Rd
Fl 2
Binghamton, NY 13905
Phone (607) 729-8156
33 Lewis Rd
Ste 2
Binghamton, NY 13905
30 Harrison St
Ste 355
Johnson City, NY 13790
Phone (607) 763-6554
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F336899-1 | NY | Yes |
Addresses
Primary practice location
30 Harrison St Ste 355
Johnson City, NY 13790-2162
Mailing address
33 Lewis Rd
2ND FL
Binghamton, NY 13905-1040
Phone (607) 729-8156
Other providers in Johnson City, NY
- Jennifer Bahr
- Larry Russell Bailey
- Kathryn Resovsky Baine
- Ata Ur Rahim Bajwa
- Maria Bajwa
- Jajji George Bako
- Edward Balaci
- Rahal Balasuriya
- Reilley Baldwin
- Vicki Bange
All providers in Johnson City, NY · Family Nurse Practitioner in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 14, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.