Individual provider Active NPI

Krista D Limburg

  • Physician Assistant
  • Murrieta, CA
National Provider Identifier
1740531706
Registry record updated Oct 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
22596 Issued in CA
Practice address
25500 Medical Center Dr
Murrieta, CA 92562-5965
Phone
(951) 696-6161
NPI assigned
Sep 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 22596 CA Primary

Addresses

Primary practice location

25500 Medical Center Dr
Murrieta, CA 92562-5965

Mailing address

25500 Medical Center Dr
Murrieta, CA 92562-5965
Phone (951) 696-6161

Other names 1

  • Krista Black Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20121026000502 CA Practitioner - Physician Assistant 6608026620 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America-California CurrentSince Oct 1, 2012 Accepting new patients

Locations

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

Organizations & group practices 3

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": "1348963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412812800000",
    "number": "1740531706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25500 MEDICAL CENTER DR",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925625965",
            "telephone_number": "951-696-6161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25500 MEDICAL CENTER DR",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925625965",
            "telephone_number": "951-696-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIMBURG",
        "first_name": "KRISTA",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-30",
        "last_updated": "2014-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "22596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTA",
            "last_name": "BLACK",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Murrieta, CA

Sources for this page

Verify at the official NPI Registry.