RON CHRISTIAN CHENG CRISOSTOMO – Nurse Practitioner, NPI 1194454900

RON CHRISTIAN CHENG CRISOSTOMO is a healthcare provider. based in Elk grove, California. specializing in NURSE PRACTITIONER. They hold a License No. 95020601 (CA). The NPI Number for RON CHRISTIAN CHENG CRISOSTOMO is 1194454900

Main info

Male
Sole Proprietor
5 Years Of Experience
Accepts Medicare Assignment
Name
RON CHRISTIAN CHENG CRISOSTOMO
NPI
1194454900
Phone
Not provided
Address
9306 BENNOEL CT
Enumeration Date
7 June 2022
Last Update Date
7 June 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2097543521
Graduation Year
2021 (5 years ago)
PAC ID
9931585452
Group Practice PAC ID
8820073711
Professional Enrollment ID
I20221005003697
Address ID
CA952499707SA768XXRDXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

16,353 NURSE PRACTITIONER in CA

Provider Addresses for RON CHRISTIAN CHENG CRISOSTOMO

  • 9306 BENNOEL CT

    ELK GROVE, CA 957587620

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-10-05

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20221005003697INurse PractitionerCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 95758)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8820073711View full group profile
NameSpecialtyState
Physician AssistantCA
-CA
General SurgeryIL
General SurgeryCA
Clinical Social WorkerCA
Orthopedic SurgeryCA
Internal MedicineCA
Clinical Social WorkerCA
Family PracticeCA
Orthopedic SurgeryNV

Reviews

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Frequently asked questions

Can I use this page to confirm RON CHRISTIAN CHENG CRISOSTOMO's NPI?
Yes. RON CHRISTIAN CHENG CRISOSTOMO is listed with NPI 1194454900 in the public NPI dataset.
Is RON CHRISTIAN CHENG CRISOSTOMO listed as active for patients and plans?
The listing shows RON CHRISTIAN CHENG CRISOSTOMO as active in the NPI system.
What is RON CHRISTIAN CHENG CRISOSTOMO's primary classification?
Nurse Practitioner is the headline specialty for RON CHRISTIAN CHENG CRISOSTOMO here. Clinical services aligned with this taxonomy classification.
What address line appears for RON CHRISTIAN CHENG CRISOSTOMO?
RON CHRISTIAN CHENG CRISOSTOMO's geographic hint is Elk Grove, California in our summary view.
Why does RON CHRISTIAN CHENG CRISOSTOMO have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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