Individual provider Active NPI

Nicholas Cristello, ARNP

  • Family Nurse Practitioner
  • Jacksonville Beach, FL
National Provider Identifier
1740720911
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9351806 Issued in FL
Practice address
1370 13TH Ave S Ste 215
Jacksonville Beach, FL 32250-3206
Phone
(904) 249-1041
Fax
(904) 249-9764
NPI assigned
Mar 7, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9351806 FL Primary

Addresses

Primary practice location

1370 13TH Ave S Ste 215
Jacksonville Beach, FL 32250-3206

Mailing address

PO Box 41113
Jacksonville, FL 32203-1113
Phone (904) 376-4400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20201201001113 FL Order and Referring Only - Nurse Practitioner 8123395936

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1488844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1740720911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41113",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322031113",
            "telephone_number": "904-376-4400",
            "fax_number": "904-391-5595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 13TH AVE S STE 215",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322503206",
            "telephone_number": "904-249-1041",
            "fax_number": "904-249-9764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISTELLO",
        "first_name": "NICHOLAS",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9351806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville Beach, FL

Sources for this page

Verify at the official NPI Registry.