Individual provider Active NPI

Cristina Breckenridge, D.O.

  • Internal Medicine Physician
  • Honolulu, HI
National Provider Identifier
1780925677
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
1780925677 Issued in VA
Practice address
2367 North Rd
St 100 BLDG 584
Honolulu, HI 96860
Phone
(808) 473-2529
NPI assigned
Mar 3, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 1780925677 VA Primary

Addresses

Primary practice location

2367 North Rd
St 100 BLDG 584
Honolulu, HI 96860

Mailing address

12820 Seneca Rd
Irving, NY 14081-9670

Other practice location 1

US NMRTC Yokosuka
Fpo, AP 96350
Phone (315) 243-7742

Other practice location 2

937 Franklin Blvd
Lemoore, CA 93246-2197
Phone (559) 998-2822

Other practice location 3

620 John Paul Jones Cir
Portsmouth, VA 23708-2197
Phone (757) 953-3149

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20190710002783 VA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 1557696762

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1780925677VAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1362268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1780925677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12820 SENECA RD",
            "city": "IRVING",
            "state": "NY",
            "postal_code": "140819670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2367 NORTH RD",
            "address_2": "ST 100 BLDG 584",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "96860",
            "telephone_number": "808-473-2529"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "US NMRTC Yokosuka",
            "address_purpose": "LOCATION",
            "city": "FPO",
            "state": "AP",
            "postal_code": "96350",
            "country_code": "US",
            "telephone_number": "315-243-7742",
            "country_name": "United States",
            "address_type": "MIL"
        },
        {
            "address_1": "937 Franklin Blvd",
            "address_purpose": "LOCATION",
            "city": "Lemoore",
            "state": "CA",
            "postal_code": "932462197",
            "country_code": "US",
            "telephone_number": "559-998-2822",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "620 John Paul Jones Cir",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "VA",
            "postal_code": "237082197",
            "country_code": "US",
            "telephone_number": "757-953-3149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRECKENRIDGE",
        "first_name": "CRISTINA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-03",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "1780925677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.