Individual provider Active NPI

Jonathan D Krystal, M.D,

  • Specialist
  • Woodbury, NY
National Provider Identifier
1770889990
Registry record updated Oct 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
284472 Issued in NY
Practice address
45 Crossways Park Dr W
Woodbury, NY 11797-2037
Phone
(516) 218-4729
Fax
(516) 992-4637
NPI assigned
Feb 4, 2011
Last updated
Oct 24, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X MD454050 PA
Orthopaedic Surgery of the Spine Physician 207XS0117X 25MA09706000 NJ
Specialist 174400000X 284472 NY Primary

Addresses

Primary practice location

45 Crossways Park Dr W
Woodbury, NY 11797-2037

Mailing address

444 Merrick Rd
Lynbrook, NY 11563-2460
Phone (516) 218-4729

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20160729001274 NY Practitioner - Orthopedic Surgery 9931414612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Connecticut School of Medicine, 2010
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

3400 Bainbridge Ave
Bronx, NY 10467-2404
Phone (914) 378-6148

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion29
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Aug 26, 2017 Accepting new patients
Montefiore Medical Center CurrentSince Aug 26, 2017 Accepting new patients
Montefiore Medical Center Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

1250 Waters Pl
Fl 11
Bronx, NY 10461
Phone (347) 577-4410

1250 Waters Pl
Ste 903
Bronx, NY 10461
Phone (718) 450-9955

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: jokrysta@montefioredirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1296777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477267200000",
    "number": "1770889990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 MERRICK RD",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115632460",
            "telephone_number": "516-218-4729",
            "fax_number": "516-992-4637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 CROSSWAYS PARK DR W",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117972037",
            "telephone_number": "516-218-4729",
            "fax_number": "516-992-4637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRYSTAL",
        "first_name": "JONATHAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-04",
        "last_updated": "2016-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "PA",
            "license": "MD454050",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "NJ",
            "license": "25MA09706000",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "284472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, NY

Sources for this page

Verify at the official NPI Registry.