CRYSTAL PAK
NPI 1033898903
Nurse Practitioner - Acute Care in Philadelphia, PA
About Crystal Pak NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CRYSTAL PAK (NPI 1033898903) is an individual acute care provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (SP026895) and active in the NPI registry since July 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2017).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Crystal Pak is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Crystal Pak reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Philadelphia, PA 19107
- Reassigned Medicare billing, Pennsylvania enrollment
- 1,739 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 19107 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PHILADELPHIA, PA 19107
PHILADELPHIA, PA 19107
PHILADELPHIA, PA 19107
PHILADELPHIA, PA 19107
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Crystal Pak's NPI number?
The NPI number for Crystal Pak is 1033898903. It was assigned to this individual provider in the NPPES registry on July 17, 2023.
Where is Crystal Pak located?
Crystal Pak practices at 111 S 11th St, Philadelphia, PA 19107. The listed phone number is (215) 873-7888.
What is Crystal Pak's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.
Is Crystal Pak enrolled in Medicare?
Yes. Crystal Pak is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Crystal Pak's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Crystal Pak reassigns Medicare benefits to Jefferson University Physicians (Philadelphia, PA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Crystal Pak's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Crystal Pak was last updated on July 17, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Crystal Pak · NPI 1033898903
Acute Care physician in Philadelphia, Pennsylvania. Individual provider, active in the CMS NPPES registry since July 17, 2023.
## Identity
- **NPI:** 1033898903 (Entity type: Individual)
- **Enumerated:** July 17, 2023
- **Primary specialty:** Nurse Practitioner - Acute Care · taxonomy 363LA2100X
- **State license:** SP026895 (Pennsylvania)
- **Sole proprietor:** No
## Practice location
- **Address:** 111 S 11TH ST, Philadelphia, PA 19107-4824
- **Phone:** (215) 873-7888
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Jefferson University Physicians (NPI 1326093675, Philadelphia, PA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2017
## Record status
- **NPPES last updated:** July 17, 2023
---
Source: [NPI Profile](https://npiprofile.com/npi/1033898903) · Data from the CMS NPPES public registry.