Look up the most recent NPI and PECOS records

Crystal Nicole Thompson

Emergency Medicine

Allopathic & Osteopathic Physicians

100 Nicolls Rd Rm 80, Stony Brook, NY 11794-8350

PECOS Enrollment

This provider is enrolled in PECOS as CRYSTAL THOMPSON.

Based on the most recent information from CMS, provider Crystal Nicole Thompson is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1578982294
Provider Type
Individual
Full Name
Thompson, Crystal Nicole
Credential
MD

Gender
Female
Sole Proprietor
No
Enumeration Date
4/9/2014
Last Updated
3/17/2018

Contact Information

Practice Location

100 Nicolls Rd Rm 80, Stony Brook, NY 11794-8350

(631) 444-2478

Unlisted Fax

Mailing Location

PO Box 1554, Stony Brook, NY 11790-0988

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207P00000X Primary	Description Emergency Medicine Allopathic & Osteopathic Physicians	License 288947-1 New York
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

Crystal Nicole Thompson

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Donnelly, Alexandra Hailey

Schiff, Lawrence Russell

Sumon, Kazi N

Tanzi, Matthew Vincent

Imperato, Michael T

Lawrence, David Talbot

Ulloa, Nicolas Alejandro

Hodges, Megan

Newton, Erika H

Morley, Eric J