Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1679561435 Individual Practitioner Female Practitioner

Jennifer A Castelluccio , PA-C

Physician Assistant • Maple Valley, WA

Professional Overview & Biography Verified Profile Summary

Jennifer Castelluccio, PA-C is a registered healthcare professional specializing in Physician Assistant in Maple Valley, WA. Practice services are available at 26458 MAPLE VALLEY BLACK DIAMOND RD SE under active NPI credentials.

Frequently performed procedures and clinical services include established patient outpatient office visit, annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

26458 Maple Valley Black Diamond Rd Se

Maple Valley, WA 98038

Telephone 4256903460
Fax 4256909460
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Maple Valley, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 19.0 Yrs
State Avg: 12.1 Yrs
Regional Practice Density
10 Specialists

Practicing in Maple Valley, WA (3774 Statewide)

Telehealth Adoption Rate
10.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
42.3% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2021)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes
65 47 $82.54 $62.50
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
30 30 $296.00 $126.96
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
14 13 $108.57 $91.45

Medical Specialties & State Licenses

CMS Verified: 2021-08-17
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License WA OA10000132

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Physician Assistant - Medical

NUCC Taxonomy Code: 363AM0700X

State License WA OA10000132

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
1016090 (WA)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners
Kristen Drury , PA-C

Physician Assistant - Medical

NPI 1053560524

Physician Assistant (Certified)

Dr. Laura Aguilar , DO

Family Medicine

NPI 1124478870

Doctor of Osteopathic Medicine (D.O.)

Lauren Kaltz , PA-C

Physician Assistant

NPI 1174243653

Physician Assistant (Certified)

Crystal Czaplicki , PA-C

Physician Assistant

NPI 1689974305

Physician Assistant (Certified)

NPI 1720723455

Doctor of Medicine (M.D.)

Dr. Telly Russell , MD

Family Medicine

NPI 1780978338

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
📍
Updated Business Mailing Address August 17, 2021

Registered at 3600 LIND AVE SW, SUITE 100 ATTN CREDENTIALING, RENTON, WA 980574970 (Tel: 4256902715)

NPI Profile Active September 17, 2014

NPI status registered as active in NPPES database

📍
Updated Practice Location September 17, 2014

Registered at 26458 MAPLE VALLEY BLACK DIAMOND RD SE, MAPLE VALLEY, WA 98038 (Tel: 4256565577)

📍
Updated Business Mailing Address September 17, 2014

Registered at PO BOX 34876, SEATTLE, WA 981241876 (Tel: 4256565412)

👤
Provider Name / Credentials Updated September 17, 2014

Recorded as JENNIFER CASTELLUCCIO, PAC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 17, 2014

Physician Assistant (License #OA10000132 in WA)

🟢
Initial NPI Registration & Enumeration October 06, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1679561435
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 06, 2005
Last Update: August 17, 2021
Sole Proprietor: No

Mailing Address

3600 Lind Ave Sw, Suite 100 Attn Credentialing

Renton, WA 980574970

Phone: 4256902715

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.