Kristine S Herlevi, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

8322950-1206 Issued in UT

Practice address

2839 St Rose Pkwy
Ste 100
Henderson, NV 89052-4806

Phone

(702) 837-8988

Fax

(702) 990-5269

NPI assigned

Mar 22, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

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

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Springville Dermatology and Diagnostics PCGroup PAC ID 5991930406, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: kristineherlevi@springvillederm.emadirect.md

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Springville Dermatology & Diagnostics PC

  • Dermatopathology Physician
  • Springville, UT
  • NPI 1992144364
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1269216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548720000000",
    "number": "1720302680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 E 3900 S",
            "address_2": "STE 200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841072332",
            "telephone_number": "801-747-2800",
            "fax_number": "801-747-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2839 ST ROSE PKWY",
            "address_2": "STE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524806",
            "telephone_number": "702-837-8988",
            "fax_number": "702-990-5269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERLEVI",
        "first_name": "KRISTINE",
        "middle_name": "S",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-22",
        "last_updated": "2019-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "8322950-1206",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "PA1211",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breanne Hensley, OTR/L
• Jackie Henson
• Jessica Nicole Hentzschel
• Trever Heppe, DPT
• Anne Heppenstall, LCSW
• Rhonda Herman-Davis
• Frederick Flint Herman, M.D.
• Jessy Hernandes
• Carlos Hernandez-Cassis, MD, MPH
• Amy Karina Hernandez

• Physician Assistant in Henderson, NV
• Providers in Henderson, NV by specialty
• Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2019; 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.