Individual provider Active NPI

Deborah Ann Kronstad, M.D.

  • Pediatrics Physician
  • Paso Robles, CA
National Provider Identifier
1972797637
Registry record updated Jun 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A104865 Issued in CA
Practice address
416 Spring St
201
Paso Robles, CA 93446-3161
Phone
(805) 238-7250
Fax
(805) 238-0165
NPI assigned
Sep 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A104865 CA Primary

Addresses

Primary practice location

416 Spring St
201
Paso Robles, CA 93446-3161

Mailing address

2050 S Blosser Rd
Santa Maria, CA 93458-7310
Phone (805) 361-8028

Other identifiers 1

IdentifierTypeStateIssuer
FHC70477FMedicaidCA

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100809000951 CA Practitioner - Pediatric Medicine 9537292701 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
104865CAMDClinical Social Worker
A104865CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Community Health Centers of the Central Coast Inc CurrentSince Jun 1, 2020 Accepting new patients
Community Health Centers of the Central Coast, Inc CurrentSince Jun 1, 2020 Accepting new patients

Locations

150 Tejas Pl
Nipomo, CA 93444
Phone (805) 929-3254

416 Spring St
Ste 201
Paso Robles, CA 93446
Phone (805) 238-7250

2050 S Blosser Rd
Santa Maria, CA 93458
Phone (805) 361-8014

1551 Bishop St
Ste A160
Sn Luis Obisp, CA 93401
Phone (805) 781-4230

325 Posada Ln
Templeton, CA 93465
Phone (805) 239-0644

Interoperability endpoints

  • Direct secure messaging: deborah.kronstad.1@17363.direct.athenahealth.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434067200000",
    "number": "1972797637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 S BLOSSER RD",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934587310",
            "telephone_number": "805-361-8028",
            "fax_number": "805-361-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 SPRING ST",
            "address_2": "201",
            "city": "PASO ROBLES",
            "state": "CA",
            "postal_code": "934463161",
            "telephone_number": "805-238-7250",
            "fax_number": "805-238-0165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRONSTAD",
        "first_name": "DEBORAH",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-05",
        "last_updated": "2015-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A104865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC70477F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paso Robles, CA

Sources for this page

Verify at the official NPI Registry.