Andrew Tistadt, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA01174 Issued in OR

Practice address

21810 Willamette Dr Ste 200
West Linn, OR 97068-3287

Phone

(503) 994-4353

Fax

(503) 722-5100

NPI assigned

Nov 9, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Telehealth

Offers telehealth services

Group practices

Holy Family Catholic Clinic P SGroup PAC ID 4587083779, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Legacy Meridian Park Medical Center Hospital, Tualatin, OR, CCN 380089
• Providence Willamette Falls Medical Center Hospital, Oregon City, OR, CCN 380038
• Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: andrew.tistadt.1@17650.direct.athenahealth.com
• Direct secure messaging: andrew.tistadt.1@22103.direct.athenahealth.com
• Direct secure messaging: atistadt865616@oc.providencedirect.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.

• Holy Family Catholic Clinic, P.S.

  • Family Medicine Physician
  • West Linn, OR
  • NPI 1619588175
  Medicare reassignment Care Compare group
• Tuality Medical Group LLC

  • Internal Medicine Physician
  • Hillsboro, OR
  • NPI 1073929782
  Medicare reassignment
• Virginia Garcia Memorial Health Center

  • Federally Qualified Health Center (FQHC)
  • Cornelius, OR
  • NPI 1679528012
  Medicare reassignment
• Tuality Medical Group LLC

  • Neurology Physician
  • Hillsboro, OR
  • NPI 1639690704
  NPD

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

• Legacy Meridian Park Hospital

  • General Acute Care Hospital
  • Tualatin, OR
  • NPI 1184647620
  Care Compare affiliation
• Oregon Health & Science University

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1609824010
  Care Compare affiliation
• Providence Health & Services - Oregon

  • Clinic/Center
  • Portland, OR
  • NPI 1326272741

  Hospital

  Care Compare affiliation
• Providence Health & Services - Oregon

  • General Acute Care Hospital
  • Oregon City, OR
  • NPI 1912282369
  Care Compare affiliation

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1831269265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21810 WILLAMETTE DR STE 200",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970683287",
            "telephone_number": "503-994-4353",
            "fax_number": "503-722-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21810 WILLAMETTE DR STE 200",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970683287",
            "telephone_number": "503-994-4353",
            "fax_number": "503-722-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISTADT",
        "first_name": "ANDREW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA01174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500622688",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Thickins, PSY.D.
• Jacob Lyn Thomason
• Jennifer Thompson
• Deborah C Thrall, MDT CERT PT
• Timber Sports Medicine & Rehabilitation
• Todd Overman Psychological, LLC
• Tom B. Curtis DMD., PC
• Total Renal Care Inc
• Henry Tran, PHARMD
• Lawrence S Tremaine, DO

• Medical Physician Assistant in West Linn, OR
• Providers in West Linn, OR by specialty
• Medical Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2026; 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.