JENNIFER JARDELEZA CRISOSTOMO (NURSE PRACTITIONER) – Family Nurse Practitioner, NPI 1659020576
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
16,538 NURSE PRACTITIONER in CA
Provider Addresses for JENNIFER JARDELEZA CRISOSTOMO (NURSE PRACTITIONER)
3333 GLENDALE BLVD STE 3
LOS ANGELES, CA 900391840
Phone: (626) 824-1121
Type: Mailing
PO BOX 80011
CITY OF INDUSTRY, CA 917168011
Phone: (626) 793-2885
Fax: (626) 793-6262
Type: Mailing
235 E BADILLO ST
COVINA, CA 917232116
Phone: (626) 915-4700
Fax: (626) 214-7815
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 21 Open Payments records for all available years, with a total value of $399.
Total Amount is formed as General ($399) + Research ($0) + Ownership ($0) = $399.
Last reported payment date: 2024-10-30 • Largest payer in this snapshot: Kiniksa Pharmaceuticals International, plc ($47).
Total Amount
$399
General + Research + Ownership
Payments
21
Total payment records
General Amount
$399
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-30
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2024-08-19
PECOS data refreshed: 2026-06-15
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240819004192 | I | Nurse Practitioner | CA | TBD |
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.
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 90039)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | CA | |
| Physician Assistant | CA | |
| Nurse Practitioner | CA | |
| Cardiovascular Disease (Cardiology), Internal Medicine | OH | |
| Cardiovascular Disease (Cardiology) | CA | |
| Cardiac Electrophysiology, Cardiovascular Disease (Cardiology) | CA | |
| Nurse Practitioner | CA | |
| Cardiovascular Disease (Cardiology), Peripheral Vascular Disease, Interventional Cardiology | CA | |
| Nurse Practitioner | CA | |
| - | CA |
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