Crystal Idstein, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2146 Issued in KY

Practice address

411 E Chestnut St # 6
Louisville, KY 40202-1713

Phone

(502) 588-9587

Fax

(502) 588-9580

NPI assigned

Mar 10, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Crystal Vahrenhold Former name

Medicare fee-for-service enrollment

Enrolled in KY

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

Merit-based Incentive Payment System (MIPS)

Final score

82.05 of 100Reported as group

Quality

68.56

Promoting interoperability

95

Improvement activities

40

Cost

75.76

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Physician Assistant

State licenses

Practice roles

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.

• Ohio Valley Pain Institute PLLC

  • Anesthesiology Physician
  • Louisville, KY
  • NPI 1639659758
  Medicare reassignment
• Norton Childrens Medical Group, LLC

  • Pediatrics Physician
  • Louisville, KY
  • NPI 1326695255

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1425945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1811380231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776879",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776879",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 E CHESTNUT ST # 6",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021713",
            "telephone_number": "502-588-9587",
            "fax_number": "502-588-9580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "619 19th St S",
            "address_2": "JT 804",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352496810",
            "country_code": "US",
            "telephone_number": "205-934-4696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IDSTEIN",
        "first_name": "CRYSTAL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-10",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "TA.1793",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA2146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "VAHRENHOLD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marina Ibrahim
• Muhammad Ibrahim, MD
• Icats Management Integrated Care and Transition Services LLC
• Ideal Image
• Lance Orbin Idleman, RPH
• Humaira Iftikhar
• Kirsten Iggins
• Bryan Thomas Iglehart Jr., MD
• Sable Iglesias, DNP
• Mark Aaron Ihnen, M.D.

• Physician Assistant in Louisville, KY
• Providers in Louisville, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.