Crystal Marie Qureshi, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3244 Issued in AZ

Practice address

14044 W Camelback Rd Ste 204
Litchfield Park, AZ 85340-9426

Phone

(623) 935-9600

Fax

(623) 935-9602

NPI assigned

Jun 17, 2006

Last updated

Mar 17, 2018By the provider in NPPES

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

• Crystal Marie Sullivan Former name

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Physician Assistant

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Pinnacle Family Medicine PLCGroup PAC ID 7012015670, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Pinnacle Family Medicine PLC

  • Family Medicine Physician
  • Litchfield Park, AZ
  • NPI 1639208325
  Medicare reassignment Care Compare group
• Pinnacle Family Medicine PLC

  • Family Medicine Physician
  • Peoria, AZ
  • NPI 1093590341
  NPD (past)
• Southwest Oncology & Hematology, PC

  • Hematology & Oncology Physician
  • Phoenix, AZ
  • NPI 1033161757
  NPD (past)

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1942245691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14044 W CAMELBACK RD STE 204",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853409426",
            "telephone_number": "623-935-9600",
            "fax_number": "623-935-9602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14044 W CAMELBACK RD STE 204",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853409426",
            "telephone_number": "623-935-9600",
            "fax_number": "623-935-9602"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14973 W Bell Rd",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Surprise",
            "state": "AZ",
            "postal_code": "853743236",
            "country_code": "US",
            "telephone_number": "623-815-2900",
            "fax_number": "623-583-1319",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21753 N 77th Ave",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "AZ",
            "postal_code": "853822110",
            "country_code": "US",
            "telephone_number": "623-935-9600",
            "fax_number": "623-935-9602",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14973 W Bell Rd",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Surprise",
            "state": "AZ",
            "postal_code": "853743236",
            "country_code": "US",
            "telephone_number": "623-815-2900",
            "fax_number": "623-583-1319",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QURESHI",
        "first_name": "CRYSTAL",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "3244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "SULLIVAN",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physician Assistant in Litchfield Park, AZ
• Providers in Litchfield Park, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.