Individual provider Active NPI

Crystal Nevins, NURSE PRACTITIONER

  • Family Medicine Physician
  • Yaphank, NY
National Provider Identifier
1801047469
Registry record updated Aug 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
346466 Issued in NY
Practice address
7 Nydia CT
Yaphank, NY 11980-9500
Phone
(631) 820-2100
NPI assigned
Oct 1, 2008
Last updated
Aug 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 346466 NY Primary

Addresses

Primary practice location

7 Nydia CT
Yaphank, NY 11980-9500

Mailing address

7 Nydia CT
Yaphank, NY 11980-9500
Phone (631) 820-2100

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201203001841 NY Practitioner - Nurse Practitioner 0345651949 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Positive Change Psychiatry PLLCGroup PAC ID 7517285455, 6 clinicians

Practice addresses (Care Compare)

175 Jericho Tpke
Syosset, NY 11791-4538
Phone (516) 364-6500

Merit-based Incentive Payment System (MIPS)

Final score
94.73 of 100Reported as group
Quality
88.19
Improvement activities
40
Cost
64.85

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
346466NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Professional Medical Care PC CurrentSince Sep 28, 2020 Accepting new patients
Positive Change Psychiatry PLLC CurrentSince Jan 5, 2023 Accepting new patients
Renew Medical of New York, PLLC Family Medicine CurrentSince Oct 25, 2022 Accepting new patients
Michael Bishai MD, LLC CurrentSince Jan 1, 2023 Accepting new patients
Ion Oltean Physician PC CurrentSince Oct 1, 2022 Accepting new patients

Locations

22 Robert R Kasin Way
Beacon, NY 12508
Phone (845) 291-3700

1481 McDonald Ave
Brooklyn, NY 11230
Phone (347) 479-1110

3923 Fort Hamilton Pkwy
Brooklyn, NY 11218
Phone (718) 314-0999

691 92nd St
Brooklyn, NY 11228
Phone (718) 567-1000

385 Seneca Ave
Ridgewood, NY 11385
Phone (201) 843-7574

3505 Veterans Memorial Hwy
Ste C
Ronkonkoma, NY 11779
Phone (631) 676-7556

175 Jericho Tpke
Ste 301
Syosset, NY 11791
Phone (516) 364-6500

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1222819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1801047469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 NYDIA CT",
            "city": "YAPHANK",
            "state": "NY",
            "postal_code": "119809500",
            "telephone_number": "631-820-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 NYDIA CT",
            "city": "YAPHANK",
            "state": "NY",
            "postal_code": "119809500",
            "telephone_number": "631-820-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEVINS",
        "first_name": "CRYSTAL",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-01",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "346466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yaphank, NY

Sources for this page

Verify at the official NPI Registry.