Individual provider Active NPI

Crystal Zilic, NP

  • Nurse Practitioner
  • Malden, MA
National Provider Identifier
1811441355
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN2303109 Issued in MA
Practice address
109 Commercial St
Malden, MA 02148-5509
Phone
(781) 388-4160
NPI assigned
Aug 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN2303109 MA Primary

Addresses

Primary practice location

109 Commercial St
Malden, MA 02148-5509

Mailing address

35 Eastern Ave
Revere, MA 02151-2736
Phone (781) 526-2563

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20170329001652 MA Practitioner - Nurse Practitioner 5496030793 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hallmark Health Medical Associates Inc CurrentSince Mar 20, 2017 Accepting new patients

Locations

109 Commercial St
Malden, MA 02148
Phone (781) 338-4160

101 Main St
Ste 204
Medford, MA 02155
Phone (781) 395-2114

425 Revere St
Revere, MA 02151
Phone (781) 286-1313

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1471046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1811441355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 EASTERN AVE",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021512736",
            "telephone_number": "781-526-2563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 COMMERCIAL ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021485509",
            "telephone_number": "781-388-4160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZILIC",
        "first_name": "CRYSTAL",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-13",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2303109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malden, MA

Sources for this page

Verify at the official NPI Registry.