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CRYSTAL COMMUNITY E N T
NPI 1669590790
Otolaryngology - Otolaryngology/Facial Plastic Surgery in Crystal River, FL

Active since March 27, 2007
790 SE 5TH TER, CRYSTAL RIVER, FL 34429(352) 795-0011(352) 795-9481 Get Directions Write a Review

NPPES record last updated: September 11, 2018. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Crystal Community E N T NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CRYSTAL COMMUNITY E N T (NPI 1669590790) is a healthcare organization registered as an otolaryngology/facial plastic surgery in Crystal River, Florida and active in the NPI registry since March 2007. The organization lists Kelly Surrency, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1669590790
Entity TypeOrganization
Primary Taxonomy207YX0905X
Legal Business NameCRYSTAL COMMUNITY E N T
Location Address790 SE 5TH TERCrystal River, FL 34429-4852
Mailing Address790 Se 5th TerCrystal River, FL 34429-4852 · (352) 795-0011 · Fax (352) 795-9481
Phone(352) 795-0011
Fax(352) 795-9481
Organization SubpartNo
Authorized OfficialKelly SurrencyOffice Manager · (352) 795-0011
Enumeration DateMarch 27, 2007
Last NPPES UpdateSeptember 11, 2018
✔ NPI 1669590790 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngology · Otolaryngology/Facial Plastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207YX0905X
License✔ Licensed in FL · OS5716
Definition
An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions.
790 SE 5TH TER, Crystal River, FL 34429
Open in Google Maps ↗

Other Identifiers 5

Other200691FL · Avmed
OtherDA5520FL · Railroad Mcr Group#
Other1409549FL · United Mine Workers
Other80221FL · Bcbs Of Florida
OtherP00062969FL · Railroad Medicare

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Crystal Community E N T is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Crystal Community E N T, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Denis Grillo, D.O.
Otolaryngology
NPI 1235127937
790 SE 5TH TER
Crystal River, FL 34429
(352) 795-0011
✔ PECOS✔ Accepts MedicareSame address
Angela Schenk, AU.D.
Qualified Audiologist
NPI 1154592293
700 SE 5TH TER STE 11
Crystal River, FL 34429
(352) 795-5377
0.1 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Community E N T's NPI number?

The NPI number for Crystal Community E N T is 1669590790. It was assigned to this organization in the NPPES registry on March 27, 2007.

Where is Crystal Community E N T located?

Crystal Community E N T is located at 790 SE 5th Ter, Crystal River, FL 34429. The listed phone number is (352) 795-0011.

What is Crystal Community E N T's specialty?

The primary specialty registered for this NPI is Otolaryngology, specializing in Otolaryngology/Facial Plastic Surgery, with taxonomy code 207YX0905X.

Is Crystal Community E N T enrolled in Medicare?

Yes. Crystal Community E N T is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Crystal Community E N T?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Crystal Community E N T, in Otolaryngology and Qualified Audiologist. A 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 the clinician's services. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Crystal Community E N T was last updated on September 11, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.