Individual provider Active NPI

Crystal Lamirande

  • Family Nurse Practitioner
  • Santa Monica, CA
National Provider Identifier
1811678451
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95025845 Issued in CA
Practice address
209 Montana Ave Apt 107
Santa Monica, CA 90403-1146
Phone
(323) 519-3500
NPI assigned
Jul 27, 2023
Last updated
Jul 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95025845 CA Primary

Addresses

Primary practice location

209 Montana Ave Apt 107
Santa Monica, CA 90403-1146

Mailing address

209 Montana Ave Apt 107
Santa Monica, CA 90403-1146
Phone (323) 519-3500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20240105004131 HI Practitioner - Nurse Practitioner 4688025349 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan IncGroup PAC ID 1850205360, 107 clinicians

Practice addresses (Care Compare)

80 Mahalani St
Wailuku, HI 96793-2531
Phone (808) 243-6180

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95025845CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan Inc CurrentSince Nov 20, 2023 Accepting new patients
Kaiser Foundation Health Plan Inc Current Accepting new patients
Kaiser Foundation Health Plan, Inc CurrentSince Nov 20, 2023 Accepting new patients

Locations

711 Kapiolani Blvd
Honolulu, HI 96813
Phone (808) 432-5312

599 Farrington Hwy
Kapolei, HI 96707
Phone (808) 432-3600

80 Mahalani St
Wailuku, HI 96793
Phone (808) 243-6000

Organizations & group practices 3

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 1

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": "1690416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1811678451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 MONTANA AVE APT 107",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904031146",
            "telephone_number": "323-519-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 MONTANA AVE APT 107",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904031146",
            "telephone_number": "323-519-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMIRANDE",
        "first_name": "CRYSTAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-27",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95025845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.