Individual provider Active NPI

Marina Krishtul, M.D.

  • Family Medicine Physician
  • Brick, NJ
National Provider Identifier
1891719449
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA07791200 Issued in NJ
Practice address
970 Route 70
Brick, NJ 08724-3502
Phone
(732) 836-6017
Fax
(732) 836-6002
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA07791200 NJ Primary

Addresses

Primary practice location

970 Route 70
Brick, NJ 08724-3502

Mailing address

29 Tuscany Dr
Jackson, NJ 08527-3169
Phone (732) 961-7271

Other names 1

  • Dr. Marina Zlotina Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20121205000448 NJ Order and Referring Only - Family PracticePractitioner - Family Practice 9931388394

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891719449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 TUSCANY DR",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085273169",
            "telephone_number": "732-961-7271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 ROUTE 70",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087243502",
            "telephone_number": "732-836-6017",
            "fax_number": "732-836-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISHTUL",
        "first_name": "MARINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA07791200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARINA",
            "last_name": "ZLOTINA",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brick, NJ

Sources for this page

Verify at the official NPI Registry.