CROSSOVER HEALTH MEDICAL GROUP (NPI# 1972034346) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972034346 |
| Entity Type | Organization |
| Organization Name | CROSSOVER HEALTH MEDICAL GROUP |
| Practice Address |
30 Rockefeller Plz 924e-4 New York NY 10112-0015 |
| Mailing Address |
15 Enterprise #300 Aliso Viejo CA 92656-2652 |
| Practice Telephone | 9498910328 |
| Mailing Telephone | 9498910328 |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2017-03-27 |
| Authorized Official Name | ANGIE SAKIOKA (QUALITY AND COMPLIANCE) |
| Authorized Official Telephone | 9498910328 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205443751 | Crossover Health Medical Group | Clinic/Center | 424 E. 4th St, Suite 100, Royal Oak, MI 48067 | 2020-09-29 |
| 1184231037 | Crossover Health Medical Group | Clinic/Center | 434 Patrol Rd, Jeffersonville, IN 47130-7754 | 2020-09-24 |
| 1982211835 | Crossover Health Medical Group | Clinic/Center | 711 W 2nd St Ste A, San Bernardino, CA 92410-3262 | 2020-09-24 |
| 1619584570 | Crossover Health Medical Group | Clinic/Center | 19901 Dix Toledo Hwy, Brownstown Twp, MI 48183-1039 | 2020-09-24 |
| 1982211843 | Crossover Health Medical Group | Clinic/Center | 5379 Hamner Ave Unit 801, Eastvale, CA 91752-1042 | 2020-09-24 |
| 1992312847 | Crossover Health Medical Group | Clinic/Center | 544 Conestoga Pkwy Ste 3, Shepherdsville, KY 40165-5676 | 2020-09-24 |
| 1639786585 | Crossover Health Medical Group | Clinic/Center | 1847 E Southern Ave Ste 3, Tempe, AZ 85282-5881 | 2020-09-24 |
| 1164039020 | Crossover Health Medical Group | Clinic/Center | 14329 Frederick St Ste 7-9, Moreno Valley, CA 92553-9003 | 2020-09-24 |
| 1821605775 | Crossover Health Medical Group | Clinic/Center | 5251 W Campbell Ave Ste 200, Phoenix, AZ 85031-1719 | 2020-09-24 |
| 1649887597 | Crossover Health Medical Group | Clinic/Center | 8343 W Van Buren St Bldg C-2, Tolleson, AZ 85353-3225 | 2020-09-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | CROSSOVER HEALTH MEDICAL GROUP, APC | 101 W Avenida Vista Hermosa, San Clemente, CA 92672-7706 |
| New York State Corporations | CROSSOVER HEALTH MEDICAL GROUP, APC | 99 Washington Avenue, Suite 1008, Albany, New York 12260 |
| Massachusetts Corporations | CROSSOVER HEALTH MEDICAL GROUP, APC | 65 Enterprise, Alisa Viejo, CA 92656 |
| Colorado Business Entities | CROSSOVER HEALTH MEDICAL GROUP, APC | 101 West Avenida Vista Hermosa, Suite 120, San Clemente, CA 92672 |
| Street Address |
30 ROCKEFELLER PLZ 924E-4 |
| City | NEW YORK |
| State | NY |
| Zip Code | 10112-0015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912008848 | Value Drugs Rock Inc | Pharmacy | 30 Rockefeller Plz, New York, NY 10112-0002 | 2006-09-25 |
| 1609123959 | Sally Anne Justine Rexach | Nurse Practitioner | 30 Rockefeller Plz, Suite 754-s, New York, NY 10112-0015 | 2012-08-06 |
| 1407128754 | Alan Schnuer | Pharmacist | 30 Rockefeller Plz, C/o Value Drugs, New York, NY 10112-0015 | 2012-02-02 |
| 1407187917 | Medcor Inc. | Clinic/Center | 30 Rockefeller Plz, Suite 754s-9, New York, NY 10112-0015 | 2010-01-22 |
| 1003021718 | Eva Andersson | Clinic/Center | 30 Rockefeller Plz, Room 750s, New York, NY 10112-0002 | 2007-05-14 |
| 1962626606 | Tanya Benenson | Internal Medicine | 30 Rockefeller Plz, Rm 750s, New York, NY 10112-0002 | 2007-04-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194922435 | Matthew Jay Liss | Specialist | 30 Rockefeller Plaza, Nbcu Medical Deptroom 750s, New York, NY 10112 | 2007-06-29 |
| 1508395310 | Katherine Tymeck | Registered Nurse | 30 Rockefeller Plz Rm 324e-4, New York, NY 10112-0015 | 2017-06-06 |
| 1659400562 | Wendy W. Kong | Nurse Practitioner | 30 Rockefeller Plz Rm 924e-4, New York, NY 10112-0015 | 2007-03-05 |
| 1801306865 | Ellen Kathleen Markey | Nurse Practitioner | 30 Rockefeller Plz Rm 924e-4, New York, NY 10112-0015 | 2017-10-04 |
| 1043466725 | Sarah Evelyn Klibanoff | Optometrist | 63 W 49th St, New York, NY 10112-1501 | 2008-08-13 |
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275148652 | Gloria Li | Specialist | 959 1st Ave, New York, NY 10022-6649 | 2020-09-11 |
| 1700495041 | Ana Rosa Perez | Specialist | 318 E 116th St, New York, NY 10029-1506 | 2020-07-22 |
| 1659995801 | Theodore Nathan Raosen | Specialist | 128 Pinehurst Ave Apt B61, New York, NY 10033-1755 | 2020-06-03 |
| 1255954301 | Courtney Foster | Specialist | 222 E 34th St # 13, New York, NY 10016-4842 | 2020-05-23 |
| 1396371852 | Laquanique Louise Lake | Specialist | 116west 32nd Street, New York, NY 10001-3212 | 2020-03-17 |
| 1205460524 | Yasmin El-hifnawi Cooper | Specialist | 2572 Frederick Douglass Blvd Unit B, New York, NY 10030-2106 | 2020-02-25 |
| 1376175992 | Patricia Ann Ebert | Specialist | 310 E 102nd St Apt 9d, New York, NY 10029-5607 | 2020-02-11 |
| 1912547928 | Roberto Manuel Gonzalez | Specialist | 250 W 108th St, New York, NY 10025-2956 | 2020-01-08 |
| 1659918639 | Delores Cody Oppecker | Specialist | 455 Fort Washington Ave Apt 53, New York, NY 10033-4631 | 2019-12-09 |
| 1174160543 | Jazmin Bernal | Specialist | 765 Riverside Dr, 3n, New York, NY 10032 | 2019-12-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.