Kristoffer Allan Ancho, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95020594 Issued in CA

Practice address

4180 La Jolla Village Dr Ste 240
La Jolla, CA 92037-1471

Phone

(866) 277-2659

Fax

(858) 779-2511

NPI assigned

Jul 26, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Center for Neurohealth IncGroup PAC ID 6103109327, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kancho@kbc-ca.direct.office.nextgen.com
• FHIR API: https://api.platform.athenahealth.com/24703/brand/1/csg/1/fhir/r4

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.

• Center for Neurohealth, Inc.

  • Behavioral Neurology & Neuropsychiatry Physician
  • La Jolla, CA
  • NPI 1154864874

  Single Specialty

  Medicare reassignment Care Compare group NPD
• The Neuron Clinic GP

  • Neurology Physician
  • Temecula, CA
  • NPI 1124582424

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1280102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1700199205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5275 MARKET ST",
            "address_2": "SUITE E",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921142212",
            "telephone_number": "619-857-6004",
            "fax_number": "619-263-7343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4180 LA JOLLA VILLAGE DR STE 240",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371471",
            "telephone_number": "866-277-2659",
            "fax_number": "858-779-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANCHO",
        "first_name": "KRISTOFFER",
        "middle_name": "ALLAN",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-26",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95020594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amos Healthcare LLC
• Amy Chiou Aminlari
• Consuelo Ann Anaya, MS, ATC
• Tomer Anbar, PH.D., CGP, CTC
• Eneh-Lieh J Ancheta, NP
• Johndel Andaya
• Brian Mark Anderson
• Cynthia Lea Anderson, CPNP
• Danica Anderson, PA-C
• Hans Johannes Anderson, M.D.

• Psychiatric/Mental Health Nurse Practitioner in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.