Carlyn Cromer, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP134107 Issued in TX

Practice address

4809 Old Bullard Rd Ste 500
Tyler, TX 75703-1248

Phone

(903) 579-7261

NPI assigned

Jun 7, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Carlyn Cusack Former name

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Oliver Street 5.01(a) Inc.

  • Dermatology Physician
  • Dallas, TX
  • NPI 1457695413

  TX

  Medicare reassignment NPD
• Dermatology Associates

  • Dermatology Physician
  • Houston, TX
  • NPI 1356523039
  NPD (past)
• Lifetime Health Center

  • Physician Assistant
  • Tyler, TX
  • NPI 1629489042
  NPD (past)

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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

{
    "created_epoch": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1912436684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 WSW LOOP 323 STE 100",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757019347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4809 OLD BULLARD RD STE 500",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757031248",
            "telephone_number": "903-579-7261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROMER",
        "first_name": "CARLYN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-07",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP134107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLYN",
            "last_name": "CUSACK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Samantha Crim
• Maria Rocio Criss-Lampton, LCSW
• Kijana Criswell, RN
• Paul Anthony Critelli, MD
• Nicole Lynn Cromeans, LMSW
• Jared Anthony Crook, FNP
• Levi Crook, DPT
• Cheryl Deeann Crosby, L.H.I.S.
• Melissa Crosman, FNP
• Nathaniel Ray Cross, MS, CCC-SLP

• All providers in Tyler, TX
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; 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.