Individual provider Active NPI

Milene Kennedy Crispin, M.D.

  • Dermatology Physician
  • Salinas, CA
National Provider Identifier
1811253040
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A130055 Issued in CA
Practice address
114 E Romie LN
Salinas, CA 93901-3126
Phone
(831) 757-1007
Fax
(831) 757-0352
NPI assigned
Apr 2, 2012
Last updated
Aug 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A130055 CA Primary

Addresses

Primary practice location

114 E Romie LN
Salinas, CA 93901-3126

Mailing address

525 South Dr Ste 115
Mountain View, CA 94040-4211
Phone (402) 369-5620

Other practice location 1

9781 Blue Larkspur Ln
Monterey, CA 93940-6509
Phone (831) 333-9008

Other names 1

  • Milene Catherine Kennedy Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170623000281 CA Practitioner - DermatologyPractitioner - Micrographic Dermatologic Surgery (MDS) 5799053377 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Micrographic Dermatologic Surgery (MDS)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Csi Medical GroupGroup PAC ID 5890916845, 104 clinicians

Practice addresses (Care Compare)

9781 Blue Larkspur LN
Suite 100
Monterey, CA 93940-6509
Phone (831) 333-9008

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.34 of 100Reported as group
Quality
90.85
Promoting interoperability
87
Improvement activities
40
Cost
71.11

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision361
Removal of skin lesions850
Removal of skin cancer1492
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy810

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A130055CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Csi Medical Group Dermatology CurrentSince Aug 1, 2017 Accepting new patients
Carlsbad and Vista Dermatology, Inc. Dermatology PastSince Jul 1, 2017 Accepting new patients
California Skin Institute, a Medical Corporation Dermatology Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Daria Maldonado, M.D., Inc Dermatology Past Accepting new patients

Locations

501 S Shore Ctr W
Ste 103A
Alameda, CA 94501
Phone (510) 227-7028

1524 McHenry Ave
Ste 470
Modesto, CA 95350
Phone (209) 525-8292

9781 Blue Larkspur Ln
Ste 100
Monterey, CA 93940
Phone (831) 333-9008

525 South Dr
Ste 115
Mountain View, CA 94040
Phone (408) 369-5600

114 E Romie Ln
Salinas, CA 93901
Phone (831) 422-4500

559 Abbott St
#A
Salinas, CA 93901
Phone (831) 422-4500

909 Hyde St
Ste 419
San Francisco, CA 94109
Phone (415) 678-5887

136 N San Mateo Dr
San Mateo, CA 94401
Phone (650) 348-1242

3562 Round Barn Cir
Ste 320
Santa Rosa, CA 95403
Phone (707) 578-1900

18988 Cox Ave
Ste B
Saratoga, CA 95070
Phone (408) 253-4407

4201 Torrance Blvd
Ste 640
Torrance, CA 90503
Phone (310) 375-9994

1934 Via Ctr
Ste B
Vista, CA 92081
Phone (760) 295-2299

Interoperability endpoints

  • Direct secure messaging: mcrispin@csinorthca.emadirect.md

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.

Hospital & facility affiliations 4

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": "1333324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1811253040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 SOUTH DR STE 115",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940404211",
            "telephone_number": "402-369-5620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 E ROMIE LN",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939013126",
            "telephone_number": "831-757-1007",
            "fax_number": "831-757-0352"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9781 Blue Larkspur Ln",
            "address_purpose": "LOCATION",
            "city": "Monterey",
            "state": "CA",
            "postal_code": "939406509",
            "country_code": "US",
            "telephone_number": "831-333-9008",
            "fax_number": "831-333-9010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRISPIN",
        "first_name": "MILENE",
        "middle_name": "KENNEDY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-02",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A130055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MILENE",
            "last_name": "KENNEDY",
            "middle_name": "CATHERINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salinas, CA

Sources for this page

Verify at the official NPI Registry.