Individual provider Active NPI

Kristie Mlynn Cyrus, N.P.

  • Nurse Practitioner
  • Fresno, CA
National Provider Identifier
1831531953
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
23249 Issued in CA
Practice address
2558 W Sample Ave
Fresno, CA 93711-1749
Phone
(559) 410-1539
NPI assigned
Jul 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

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 23249 CA Primary

Addresses

Primary practice location

2558 W Sample Ave
Fresno, CA 93711-1749

Mailing address

2558 W Sample Ave
Fresno, CA 93711-1749

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151001002914 CA Practitioner - Nurse Practitioner 0345558805 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
J. Scott Boswell, MD a Medical Corporation CurrentSince Jul 1, 2015 Accepting new patients

Locations

5701 N West Ave
Fresno, CA 93711
Phone (559) 439-3000

5709 N West Ave
Fresno, CA 93711
Phone (559) 243-9990

6730 N West Ave
Fresno, CA 93711
Phone (559) 439-3000

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": "1374105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1831531953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2558 W SAMPLE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937111749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2558 W SAMPLE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937111749",
            "telephone_number": "559-410-1539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CYRUS",
        "first_name": "KRISTIE",
        "middle_name": "MLYNN",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-18",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "23249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.