Active NPI
Caitlin Anne Cristante, MD
- Pediatrics Physician
- Philadelphia, PA
National Provider Identifier
1992330138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MT222403
- Practice address
- 3401 Civic Center Blvd
Philadelphia, PA 19104-4319 - Phone
- (215) 590-1220
- NPI assigned
- Mar 9, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | MT222403 | PA | Primary |
Addresses
Primary practice location
3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Mailing address
3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Other practice location 1
2160 S 1st Ave
Maywood, IL 60153-3328
Phone (704) 989-2536
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT222403 | PA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621987200000",
"number": "1992330138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3401 CIVIC CENTER BLVD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 CIVIC CENTER BLVD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044319",
"telephone_number": "215-590-1220"
}
],
"practiceLocations": [
{
"address_1": "2160 S 1st Ave",
"address_purpose": "LOCATION",
"city": "Maywood",
"state": "IL",
"postal_code": "601533328",
"country_code": "US",
"telephone_number": "704-989-2536",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CRISTANTE",
"first_name": "CAITLIN",
"middle_name": "ANNE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-09",
"last_updated": "2021-05-26",
"certification_date": "2021-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "MT222403",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
- Michelle Ann Crispin
- Mario A Cristancho Pimiento, MD
- Ana Gabriela Cristancho, M.D., PH.D.
- Daniel Antonio Cristancho, M.D.
- Roxanne Sebeny Cristancho, CRNP
- Veronica Cristiano
- Melanie Nicole Cristobal, DMD
- Elizabeth Adele Cristofalo, M.D.
- Jorie Marissa Cristy, PHARMD
- Critical Care Medicine Services LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.