Individual provider Active NPI

Kristyn Cummings, MD

  • Pediatrics Physician
  • Galveston, TX
National Provider Identifier
1730534249
Registry record updated Jun 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
BP10056547 Issued in TX
Practice address
301 University Blvd
Galveston, TX 77555-1119
Phone
(409) 772-3695
Fax
(409) 772-3680
NPI assigned
May 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X S1793 TX
Pediatrics Physician 208000000X BP10056547 TX Primary

Addresses

Primary practice location

301 University Blvd
Galveston, TX 77555-1119

Mailing address

301 University Blvd
Galveston, TX 77555-0354
Phone (409) 747-0534

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL kncummin@utmb.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20220812002860 AZ Practitioner - Pediatric Medicine 3870855133 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Texas Medical Branch at Galveston, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner-University Medical GroupGroup PAC ID 7719899871, 1,066 clinicians

Practice addresses (Care Compare)

1625 N Campbell Ave
Tucson, AZ 85719-4330
Phone (520) 694-0111

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10056547TXMDPediatrics Physician
S1793TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner-University Medical Group CurrentSince Sep 1, 2022 Accepting new patients
Banner-University Medical Group CurrentSince Sep 1, 2022 Accepting new patients
Banner-University Medical Group Family Medicine Current Accepting new patients
Banner - University Medical Center Tucson Campus LLC Past Accepting new patients

Locations

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

1625 N Campbell Ave
Tucson, AZ 85719

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.

NPI Registry JSON

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

{
    "created_epoch": "1462233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1730534249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775550354",
            "telephone_number": "409-747-0534",
            "fax_number": "409-747-0721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775551119",
            "telephone_number": "409-772-3695",
            "fax_number": "409-772-3680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUMMINGS",
        "first_name": "KRISTYN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-03",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "S1793",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "BP10056547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "kncummin@utmb.edu",
            "affiliation": "N",
            "address_1": "301 University Blvd",
            "city": "Galveston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "775551119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Galveston, TX

Sources for this page

Verify at the official NPI Registry.