Individual provider Active NPI

Kristin Staniszewski, CRNP

  • Adult Health Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1992702468
Registry record updated May 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP9600 Issued in AZ
Practice address
4550 E Bell Rd Ste 170
Phoenix, AZ 85032-9385
Phone
(480) 443-8400
Fax
(480) 443-8697
NPI assigned
Jun 30, 2005
Last updated
May 20, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X P62779 PA
Adult Health Nurse Practitioner 363LA2200X AP9600 AZ Primary

Addresses

Primary practice location

4550 E Bell Rd Ste 170
Phoenix, AZ 85032-9385

Mailing address

4550 E Bell Rd Ste 170
Phoenix, AZ 85032-9385
Phone (480) 443-8400

Other identifiers 2

IdentifierTypeStateIssuer
Z221266OtherAZMEDICARE
101001097MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040220000153 PA Practitioner - Nurse Practitioner 5294620928 Reassigns benefits to 1 organization
I20181228001483 AZ Practitioner - Nurse Practitioner 5294620928 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arizona Arthritis and Rheumatology Associates P CGroup PAC ID 8123912516, 63 clinicians

Practice addresses (Care Compare)

4550 E Bell Rd
Suite 170
Phoenix, AZ 85032-9385
Phone (480) 443-8400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
P62779PAMDNurse Practitioner
AP9600AZMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tower Health Medical Group Current Accepting new patients
Tower Health Medical Group CurrentSince Dec 1, 2003 Accepting new patients
Tower Health Medical Group CurrentSince Dec 1, 2003 Accepting new patients
Berks Endocrinology,LLC PastSince Jun 14, 2010 Accepting new patients
Berks Diabetes Management Adult Health PastSince Nov 1, 2015 Accepting new patients

Locations

301 S 7th Ave
Ste 130
West Reading, PA 19611
Phone (610) 988-4630

6 Spruce St
West Reading, PA 19611
Phone (484) 628-8269

2610 Keiser Blvd
Wyomissing, PA 19610
Phone (484) 628-9127

Interoperability endpoints

  • Direct secure messaging: kristin.staniszewski.p1@direct.aara.nextgenshare.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558310400000",
    "number": "1992702468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 E BELL RD STE 170",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850329385",
            "telephone_number": "480-443-8400",
            "fax_number": "480-443-8697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 E BELL RD STE 170",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850329385",
            "telephone_number": "480-443-8400",
            "fax_number": "480-443-8697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANISZEWSKI",
        "first_name": "KRISTIN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-30",
        "last_updated": "2019-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "P62779",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "AP9600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "Z221266",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101001097",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.