Individual provider Active NPI

Kristy Leu Hutputtanasin, NP

  • Family Nurse Practitioner
  • Orange, CA
National Provider Identifier
1740786284
Registry record updated Dec 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95008450 Issued in CA
Practice address
1010 W la Veta Ave Ste 360
Orange, CA 92868-4300
Phone
(714) 245-0492
Fax
(714) 245-0494
NPI assigned
Apr 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 818199 CA
Family Nurse Practitioner 363LF0000X 95008450 CA Primary

Addresses

Primary practice location

1010 W la Veta Ave Ste 360
Orange, CA 92868-4300

Mailing address

1010 W la Veta Ave Ste 360
Orange, CA 92868-4300
Phone (714) 245-0492

Other practice location 1

5581 Alton Pkwy
Irvine, CA 92618-4056
Phone (949) 222-9158

Other practice location 2

6261 Stanton Ave
Buena Park, CA 90621-2436
Phone (714) 739-4325

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
I20180509002893 CA Practitioner - Nurse Practitioner 8729342233 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
818199CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group Current Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Apr 16, 2018 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Apr 16, 2018 Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

6261 Stanton Ave
Buena Park, CA 90621
Phone (714) 739-4325

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

5581 Alton Pkwy
Irvine, CA 92618
Phone (949) 222-9158

15775 Laguna Canyon Rd
Ste 210
Irvine, CA 92618
Phone (949) 222-9158

15775 Laguna Canyon Rd
Irvine, CA 92618
Phone (617) 455-2048

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1740786284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 W LA VETA AVE STE 360",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684300",
            "telephone_number": "714-245-0492",
            "fax_number": "714-245-0494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 W LA VETA AVE STE 360",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684300",
            "telephone_number": "714-245-0492",
            "fax_number": "714-245-0494"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5581 Alton Pkwy",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "CA",
            "postal_code": "926184056",
            "country_code": "US",
            "telephone_number": "949-222-9158",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6261 Stanton Ave",
            "address_purpose": "LOCATION",
            "city": "Buena Park",
            "state": "CA",
            "postal_code": "906212436",
            "country_code": "US",
            "telephone_number": "714-739-4325",
            "fax_number": "714-739-4076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUTPUTTANASIN",
        "first_name": "KRISTY",
        "middle_name": "LEU",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-03",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "818199",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95008450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.