Stephanie Sirisithi, DNP, ARNP, AGNP-C

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

AP61348163 Issued in WA

Practice address

4686 Pointes Dr Ste 219
Mukilteo, WA 98275-6038

Phone

(425) 405-8089

Fax

(425) 426-2277

NPI assigned

Apr 5, 2022

Sex

Female

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians

Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Novari Primary Care LLCGroup PAC ID 3476815051, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Evergreenhealth Home Care Services Home health agency, Kirkland, WA, CCN 507079
• Assured Home Health Home health agency, Mountlake Terrace, WA, CCN 507099
• Signature Healthcare at Home Home health agency, Federal Way, WA, CCN 507110
• Evergreen Health Hospice Care Hospice, Kirkland, WA, CCN 501523
• Swedish Edmonds Hospital Hospital, Edmonds, WA, CCN 500026

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Novari Primary Care LLC

  • Nurse Practitioner
  • Mukilteo, WA
  • NPI 1598272155

  Gerontology

  Medicare reassignment Care Compare group NPD
• Select Rehabilitation, LLC

  • Rehabilitation Clinic/Center
  • Glenview, IL
  • NPI 1346368248
  Care Compare group

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

• King County Public Hospital District No. 2

  dba EvergreenHealth Hospice Care

  • Community Based Hospice Care Agency
  • Kirkland, WA
  • NPI 1285719609
  Care Compare affiliation
• King County Public Hospital District No. 2

  dba EvergreenHealth Home Care

  • Home Health Agency
  • Kirkland, WA
  • NPI 1588662761
  Care Compare affiliation
• LHCG Lxiii, LLC

  dba Assured Home Health

  • Home Health Agency
  • Mountlake Terrace, WA
  • NPI 1770998528
  Care Compare affiliation
• Maritime Healthcare LLC

  dba Signature Healthcare at Home

  • Home Health Agency
  • Federal Way, WA
  • NPI 1518701168
  Care Compare affiliation
• Swedish Edmonds

  • General Acute Care Hospital
  • Edmonds, WA
  • NPI 1033107214
  Care Compare affiliation
• Swedish Edmonds

  • Clinical Medical Laboratory
  • Edmonds, WA
  • NPI 1699894022

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1356082549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4686 POINTES DR STE 219",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "982756038",
            "telephone_number": "425-405-8089",
            "fax_number": "425-426-2277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4686 POINTES DR STE 219",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "982756038",
            "telephone_number": "425-405-8089",
            "fax_number": "425-426-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRISITHI",
        "first_name": "STEPHANIE",
        "credential": "DNP, ARNP, AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WA",
            "license": "AP61348163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Maurine Jarvis Shomler
• Robert Shumate, PT
• Ramneek Kaur Sidhu, CBT
• Dawda Sidibeh
• Geoffrey Michael Simkins, MSW
• Sheila Marie Skemp, OTR-L
• Kevlin Slingwine, DNP, ARNP, AGNP-C
• Joshua Sloane I
• Smile Studio NW, LLC
• Ansebe Smit

• Gerontology Nurse Practitioner in Mukilteo, WA
• Providers in Mukilteo, WA by specialty
• Gerontology Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; 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.