Crystal Irene Tallman, D.O.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

R5046 Issued in TX

Practice address

3042 N Federal Hwy Ste 100
Ft Lauderdale, FL 33306-1400

Phone

(954) 776-4877

NPI assigned

Jul 28, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Ms. Crystal Irene Behofsits Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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 and National Provider Directory roles.

• Mark Gottesman MD PLLC

  • Obstetrics & Gynecology Physician
  • Houston, TX
  • NPI 1104071844
  NPD (past)

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

{
    "created_epoch": "1311811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1972881654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3042 N FEDERAL HWY STE 100",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333061400",
            "telephone_number": "954-776-4877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3042 N FEDERAL HWY STE 100",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333061400",
            "telephone_number": "954-776-4877"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21110 Biscayne Blvd Ste 312",
            "address_purpose": "LOCATION",
            "city": "Aventura",
            "state": "FL",
            "postal_code": "331801229",
            "country_code": "US",
            "telephone_number": "305-933-3030",
            "fax_number": "305-933-1436",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7580 Fannin St Ste 330",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770541940",
            "country_code": "US",
            "telephone_number": "713-797-0060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TALLMAN",
        "first_name": "CRYSTAL",
        "middle_name": "IRENE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-28",
        "last_updated": "2021-08-04",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "R5042",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "OS17129",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "R5046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OS17129",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "crystal.tallman@floridawomancare.com",
            "affiliation": "N",
            "endpointDescription": "work email",
            "address_1": "21110 Biscayne Blvd Ste 312",
            "city": "Aventura",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331801229",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "eliteobgyn.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "address_1": "3042 N Federal Hwy Ste 100",
            "city": "Fort Lauderdale",
            "state": "FL",
            "country_code": "US",
            "postal_code": "333061400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "BEHOFSITS",
            "middle_name": "IRENE",
            "prefix": "MS.",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nizar H Taki, M.D.
• Alexander Takshyn, DMD
• Corie Talano
• Jeffrey Talarek, MD
• Whitney Talley, LMT
• Natalie Marie Talpesh, LCSW
• Stephanie Tamayo
• Sarosh Tamboli, DO
• Vincent Tamburelli, LCSW
• Michael Tamburrino

• Obstetrics & Gynecology Physician in Ft Lauderdale, FL
• Providers in Ft Lauderdale, FL by specialty
• Obstetrics & Gynecology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2021; 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.