NPIMap

Individual provider Active NPI

Andrea Cigliola, PA-C

  • Physician Assistant
  • Olympia, WA
National Provider Identifier
1851819460
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60902333 Issued in WA
Practice address
304 W Bay Dr NW
Olympia, WA 98502-4958
Phone
(360) 413-8760
NPI assigned
Sep 3, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X PA60902333 WA Primary

Addresses

Primary practice location

304 W Bay Dr NW
Olympia, WA 98502-4958

Mailing address

4530 79TH Ave SW
Olympia, WA 98512-2481
Phone (619) 942-4515

Other practice location 1

MEDEX Northwest 4311 11th Avenue NE Suite 200
Seattle, WA 98105
Phone (206) 616-4001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181228002179 WA Practitioner - Physician Assistant 1456696087 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology and Allergy SpecialistsGroup PAC ID 1254302698, 6 clinicians

Practice addresses (Care Compare)

304 W Bay Dr NW
Suite 301
Olympia, WA 98502-4957
Phone (360) 413-8760

304 W Bay NW
Suite 301
Olympia, WA 98502-4957

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.85 of 100Reported as individual
Quality
77.7
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA60902333WAMDPhysician Assistant

Organizations & group practices 1

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 5

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": "1504396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1851819460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4530 79TH AVE SW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985122481",
            "telephone_number": "619-942-4515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 W BAY DR NW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985024958",
            "telephone_number": "360-413-8760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "MEDEX Northwest 4311 11th Avenue NE Suite 200",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "98105",
            "country_code": "US",
            "telephone_number": "206-616-4001",
            "fax_number": "206-616-3889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CIGLIOLA",
        "first_name": "ANDREA",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60902333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.