Theodore Crisostomo-Wynne, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

MD61305294 Issued in WA

Practice address

Madigan Army Medical Center 9040 Jackson Ave
Tacoma, WA 98431-0001

Phone

(253) 968-1110

NPI assigned

Feb 14, 2017

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, OR2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Urology

Education

Uniformed Services Uhs Fe Hebert School of Med, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Salem HealthGroup PAC ID 8628986668, 470 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Salem Hospital Hospital, Salem, OR, CCN 380051
• Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Multicare Health System

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  Medicare reassignment Care Compare group NPD
• Salem Health

  • General Acute Care Hospital
  • Salem, OR
  • NPI 1265431829
  Medicare reassignment Care Compare group NPD
• Multicare Health System

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD
• Multicare Health System

  • Pediatrics Physician
  • Federal Way, WA
  • NPI 1407409741
  NPD
• The Association of University Physicians

  • Anesthesiology Physician
  • Seattle, WA
  • NPI 1023041159

  Urology

  NPD
• Salem Health

  • Durable Medical Equipment & Medical Supplies
  • Keizer, OR
  • NPI 1487434775
  NPD
• Salem Health

  • Family Medicine Physician
  • Woodburn, OR
  • NPI 1578112066
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Multicare Health System

  • General Acute Care Hospital
  • Tacoma, WA
  • NPI 1366556227
  Care Compare affiliation
• Salem Health

  • General Acute Care Hospital
  • Salem, OR
  • NPI 1265431829
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1487030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754179200000",
    "number": "1316486186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-968-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISOSTOMO-WYNNE",
        "first_name": "THEODORE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-14",
        "last_updated": "2025-08-03",
        "certification_date": "2025-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WA",
            "license": "MD61305294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eve Campbell Cremers, DO
• Randy Wayne Cressler, DPT
• Agatha Cretzu, PMHNP-BC
• Laura Crews, R.N.
• Lieu Crews
• Brianna Keri Crisostomo
• Dawnrene' Crisostomo, RN
• Yacenia Crisostomo
• Paris Crispin
• Critical Time Intervention Pierce County

• Urology Physician in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Urology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.