Cederick Deon Cistrunk, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

5601004965 Issued in MI

Practice address

3990 John R St
Detroit, MI 48201-2018

Phone

(313) 745-8040

NPI assigned

Mar 29, 2007

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 MI

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

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

VHS Physicians of MichiganGroup PAC ID 8921289760, 219 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sinai-Grace Hospital Hospital, Detroit, MI, CCN 230024

Merit-based Incentive Payment System (MIPS)

Final score

90.26 of 100Reported as group

Quality

64.16

Promoting interoperability

100

Improvement activities

40

Cost

73.79

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: ccistrun@direct.dmc.org

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.

• VHS Physicians of Michigan

  dba DMC Medical Group

  • Internal Medicine Physician
  • Southfield, MI
  • NPI 1073827101
  Medicare reassignment Care Compare group
• DMC Orthopedic Billing Associates LLC

  dba DMC Billing Associates, LLC

  • Orthopaedic Surgery Physician
  • Detroit, MI
  • NPI 1457387607
  NPD (past)

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

• VHS Sinai-Grace Hospital Inc

  dba Sinai-Grace Hospital

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1760794044
  Care Compare affiliation

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263254400000",
    "number": "1770602500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3990 JOHN R DEPT OF CARDIO THORACIC SURGERY",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48201",
            "telephone_number": "313-745-7045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012018",
            "telephone_number": "313-745-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CISTRUNK",
        "first_name": "CEDERICK",
        "middle_name": "DEON",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2010-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MI",
            "license": "5601004965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa Marie Cirocco, N.P.
• Kevin Louis Cischke, NP
• Lauren Cislo
• Ligia Elena Cisneros-Gonzalez, M.D
• Eugenia B Cissoko I
• Citizens Pharmacy Inc (Citizens pharmacy)
• Citizens Pharmacy Inc (Citizens Pharmacy)
• Kenneth Citron
• City Drugs Pharmacy
• City Home Care, LLC

• Surgical Physician Assistant in Detroit, MI
• Providers in Detroit, MI by specialty
• Surgical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2010; 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.