Crystal Mac, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

111 N Sepulveda Blvd Ste 210
Manhattan Beach, CA 90266-6849

Phone

(310) 379-2134

NPI assigned

Jul 3, 2017

Last updated

Jul 26, 2017By 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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Centinela Freeman Emergency Medical Associates, Inc.

  • Emergency Medicine Physician
  • Inglewood, CA
  • NPI 1528333101
  Medicare reassignment
• East la Emergency Physicians, Inc.

  • Emergency Medicine Physician
  • Los Angeles, CA
  • NPI 1588198055
  Medicare reassignment
• Gem Medical Group Corporation

  • Emergency Medicine Physician
  • Whittier, CA
  • NPI 1689364721
  Medicare reassignment
• Huntington Park Emergency Physicians, Inc

  • Emergency Medicine Physician
  • Huntington Park, CA
  • NPI 1053747121
  Medicare reassignment
• Gem Medical Group Corporation

  dba GEM Medical Group

  • Emergency Medicine Physician
  • Monterey Park, CA
  • NPI 1689386815
  NPD

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

{
    "created_epoch": "1499040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501027200000",
    "number": "1942721642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1218 EDITH AVE APT G",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918032476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N SEPULVEDA BLVD STE 210",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902666849",
            "telephone_number": "310-379-2134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAC",
        "first_name": "CRYSTAL",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-03",
        "last_updated": "2017-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luxottica of America Inc (LensCrafters At Macy's #3374)
• Luxottica Retail North America Inc. (Target Optical #8548)
• Tony Ly
• M. Jack Hsieh, D.D.S. and Jenny C., Au, D.D.S., Inc
• M&L in-Homecare Services
• Nadine Macaluso, LMFT
• Jamie L Macdougall, MD
• Mahsa Madani, MD
• Ashley Fowler Magovern, M.D.
• Kelly Jane Maher, PMHNP-BC

• Physician Assistant in Manhattan Beach, CA
• Providers in Manhattan Beach, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.