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THEODORE CRISOSTOMO-WYNNE MD
NPI 1316486186
Urology in Tacoma, WA

Active since February 14, 2017PECOS EnrolledAccepts Medicare Assignment
MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE, TACOMA, WA 98431(253) 968-1110 Get Directions Write a Review

NPPES record last updated: August 3, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 25, 2022, Apr 22, 2022, Feb 14, 2017 (3 updates tracked since 2017).

About Theodore Crisostomo-wynne Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THEODORE CRISOSTOMO-WYNNE MD (NPI 1316486186) is an individual urology provider in Tacoma, Washington, licensed in Washington (MD61305294) and active in the NPI registry since February 2017. He is enrolled in Medicare PECOS, is affiliated with Salem Hospital, and is a graduate of Uniformed Services Uhs Fe Hebert School Of Med (2017).

NPPES Registry Identity

NPI1316486186
Entity TypeIndividualMale
Primary Taxonomy208800000X
Provider Legal NameTHEODORE CRISOSTOMO-WYNNECredential: MD
Location AddressMADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVETacoma, WA 98431-0001
Mailing AddressPo Box 50095Seattle, WA 98145-5095
Phone(253) 968-1110
Sole ProprietorNo
Medical School CMSUniformed Services Uhs Fe Hebert School Of MedGraduated 2017
Enumeration DateFebruary 14, 2017
Last NPPES UpdateAugust 3, 20253 updates tracked since enumeration
NPPES CertifiedAugust 3, 2025
✔ NPI 1316486186 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
License✔ Licensed in WA · MD61305294
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE, Tacoma, WA 98431
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Theodore Crisostomo-wynne Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3072877588
PECOS Enrollment IDI20220825003455, I20250523000549
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Salem Hospital

Acute Care Hospitals · Salem, OR
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number380051
Location890 Oak Street, SESalem, OR 97301 · Marion County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98431 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$130.99 typical visit price
range $57.27 – $172.80
Typical copayment $32.74 (range $14.31 – $43.20)
Most-billed visit code 99204
Established Patient
$71.29 typical visit price
range $18.56 – $141.11
Typical copayment $17.82 (range $4.64 – $35.27)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KENNETH E CLIFTON MS
Social Worker (Clinical)
MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE
TACOMA, WA 98431
Pierce County (253) 968-4631
DR. MICHAEL ANTHONY D'ANGELO JR. PSY.D.
Psychologist (Clinical)
MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE
TACOMA, WA 98431
Pierce County (253) 968-5370
CHLOE WYEN LMHC
Counselor (Mental Health)
MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE
TACOMA, WA 98431
Pierce County (253) 968-0002
CRYSTAL-ANN SPANN RN
Registered Nurse (Case Management)
MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE
TACOMA, WA 98431
Pierce County (253) 966-3677
DR. JONATHAN LEE CAMERON DNP, CRNA
Military Health Care Provider
MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE
TACOMA, WA 98431
Pierce County (253) 968-2252
MARGARET MARY FAHY PA
Physician Assistant (Medical)
MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE
TACOMA, WA 98431
Pierce County (253) 968-0432
MICHAEL A. BORK DO
General Practice
MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE
TACOMA, WA 98431
Pierce County (253) 968-2462
DR. PETER STULL MD
Emergency Medicine
MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE
TACOMA, WA 98431
Pierce County (253) 968-1250

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theodore Crisostomo-wynne's NPI number?

The NPI number for Theodore Crisostomo-wynne is 1316486186. It was assigned to this individual provider in the NPPES registry on February 14, 2017.

Where is Theodore Crisostomo-wynne located?

Theodore Crisostomo-wynne practices at Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431. The listed phone number is (253) 968-1110.

What is Theodore Crisostomo-wynne's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Theodore Crisostomo-wynne enrolled in Medicare?

Yes. Theodore Crisostomo-wynne is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Theodore Crisostomo-wynne accept?

Health plans from Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Theodore Crisostomo-wynne as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Theodore Crisostomo-wynne affiliated with any hospitals?

According to CMS data, Theodore Crisostomo-wynne is affiliated with Salem Hospital.

When was this NPI record last updated?

The NPPES record for Theodore Crisostomo-wynne was last updated on August 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.