Individual provider Active NPI

Crista Hickey, FNP-C

  • Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1932769122
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN2307649 Issued in CA
Practice address
9095 Rio San Diego Dr Ste 425
San Diego, CA 92108-1679
Phone
(858) 455-5524
Fax
(858) 587-9377
NPI assigned
Jun 19, 2019
Last updated
Sep 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN2307649 CA Primary
Registered Nurse 163W00000X RN2307649 CA

Addresses

Primary practice location

9095 Rio San Diego Dr Ste 425
San Diego, CA 92108-1679

Mailing address

9095 Rio San Diego Dr Ste 425
San Diego, CA 92108-1679
Phone (858) 455-5524

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220201001904 MA Practitioner - Nurse Practitioner 3476952573 Reassigns benefits to 2 organizations
I20250923004137 CA Practitioner - Nurse Practitioner 3476952573 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
South Coast Gynecologic Oncology IncGroup PAC ID 1557366556, 7 clinicians

Practice addresses (Care Compare)

9095 Rio San Diego Dr
Suite 425
San Diego, CA 92108-1679
Phone 8584555524205

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2307649CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Dec 23, 2021 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Dec 23, 2021 Accepting new patients
South Coast Gynecologic Oncology, Inc CurrentSince Sep 15, 2025 Accepting new patients

Locations

9095 Rio San Diego Dr
Ste 425
San Diego, CA 92108
Phone 8584555524 ext. 205

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

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 5

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": "1560902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1932769122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9095 RIO SAN DIEGO DR STE 425",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081679",
            "telephone_number": "858-455-5524",
            "fax_number": "858-587-9377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9095 RIO SAN DIEGO DR STE 425",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081679",
            "telephone_number": "858-455-5524",
            "fax_number": "858-587-9377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKEY",
        "first_name": "CRISTA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-19",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "RN2307649",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "RN2307649",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.