Individual provider Active NPI

Andrea Lauren Cistulli, DO

  • Family Medicine Physician
  • Seattle, WA
National Provider Identifier
1427672310
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP61303898 Issued in WA
Practice address
4550 Fauntleroy Way SW Ste 100
Seattle, WA 98126-3471
Phone
(206) 933-1041
Fax
(206) 933-1047
NPI assigned
Jun 5, 2020
Last updated
Feb 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OP61303898 WA Primary

Addresses

Primary practice location

4550 Fauntleroy Way SW Ste 100
Seattle, WA 98126-3471

Mailing address

4550 Fauntleroy Way SW Ste 100
Seattle, WA 98126-3471
Phone (206) 933-1041

Other identifiers 1

IdentifierTypeStateIssuer
2160381MedicaidWA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address acistulli83967@direct.valleymed.org Direct
FHIR URL https://FHIR.valleymed.org/FHIR-PRD/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231010001535 WA Practitioner - Family Practice 3476976424 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University, Arizona School of Dentistry & Oral HLTH, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

4550 Fauntleroy Way SW
Seattle, WA 98126-2740
Phone (206) 971-0425

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group Family Medicine CurrentSince Sep 19, 2023 Accepting new patients
Franciscan Medical Group Family Medicine Past Accepting new patients
Highline Medical Group Inc Family Medicine PastSince Feb 25, 2024 Accepting new patients

Locations

34503 9th Ave S
Ste 130
Federal Way, WA 98003
Phone (253) 835-5340

4550 Fauntleroy Way SW
Seattle, WA 98126
Phone (206) 933-1041

4550 Fauntleroy Way SW
Ste 100
Seattle, WA 98126
Phone (206) 403-1601

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Interoperability endpoints

  • Direct secure messaging: acistulli807874@fhsce.catholichealth.net

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1591315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1427672310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 FAUNTLEROY WAY SW STE 100",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981263471",
            "telephone_number": "206-933-1041",
            "fax_number": "206-933-1047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 FAUNTLEROY WAY SW STE 100",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981263471",
            "telephone_number": "206-933-1041",
            "fax_number": "206-933-1047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CISTULLI",
        "first_name": "ANDREA",
        "middle_name": "LAUREN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-05",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP61303898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2160381",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "acistulli83967@direct.valleymed.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "acistulli83967@direct.valleymed.org",
            "address_1": "3915 Talbot Rd S Ste 401",
            "city": "Renton",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980555738",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://FHIR.valleymed.org/FHIR-PRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "3915 Talbot Rd S Ste 401",
            "city": "Renton",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980555738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.