CRYSTAL CHARLOTTE KOSTELYK (ARNP) – School Registered Nurse, NPI 1376916510

CRYSTAL CHARLOTTE KOSTELYK (ARNP) is a healthcare provider. based in Des moines, Washington. specializing in NURSE PRACTITIONER. They hold the professional credentials ARNP. They hold a License No. AP61455830 (WA). The NPI Number for CRYSTAL CHARLOTTE KOSTELYK (ARNP) is 1376916510

Main info

Female
Sole Proprietor
3 Years Of Experience
Accepts Medicare Assignment
Name
CRYSTAL CHARLOTTE KOSTELYK (ARNP)
NPI
1376916510
Phone
(206) 631-4707
Address
2104 S 247TH ST
Enumeration Date
10 November 2015
Last Update Date
11 March 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8006403451
Graduation Year
2023 (3 years ago)
PAC ID
6800259482
Group Practice PAC ID
6103268560
Professional Enrollment ID
I20230830000483
Address ID
WA980334677KI11417NEXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience49
Completeness75
Years active:10State licenses:1Digital endpointsOther names

6,261 NURSE PRACTITIONER in WA

Provider Addresses for CRYSTAL CHARLOTTE KOSTELYK (ARNP)

  • 2104 S 247TH ST

    DES MOINES, WA 981983901

    Phone: (206) 631-4707

    Fax: (206) 631-4760

    Type: Mailing

  • 11417 124TH AVE NE STE 100

    KIRKLAND, WA 980334677

    Phone: (800) 640-3451

    Type: Location

  • PO BOX 1200

    PLEASANT GROVE, UT 840621200

    Phone: (800) 640-3451

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-08-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230830000483INurse PractitionerWATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98198)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6103268560View full group profile
NameSpecialtyState
Nurse PractitionerPA
Nurse PractitionerTX
Nurse PractitionerPA
Nurse PractitionerCO
Nurse PractitionerUT
Nurse PractitionerVA
Nurse PractitionerPA
Nurse PractitionerKY
Nurse PractitionerTX
Nurse PractitionerUT

Reviews

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Frequently asked questions

What is the registry number for CRYSTAL CHARLOTTE KOSTELYK (ARNP)?
The registry entry for CRYSTAL CHARLOTTE KOSTELYK (ARNP) shows NPI 1376916510.
Does the public listing show CRYSTAL CHARLOTTE KOSTELYK (ARNP) as active?
CRYSTAL CHARLOTTE KOSTELYK (ARNP)'s NPI record reflects an active status in NPPES.
What does the directory say CRYSTAL CHARLOTTE KOSTELYK (ARNP) does?
Insurance directories may phrase it differently, but here CRYSTAL CHARLOTTE KOSTELYK (ARNP) maps to School Registered Nurse. Clinical services aligned with this taxonomy classification.
What city is tied to CRYSTAL CHARLOTTE KOSTELYK (ARNP)?
The directory associates CRYSTAL CHARLOTTE KOSTELYK (ARNP) with Des Moines, Washington. Check all listed addresses for suites or satellite offices.
Who maintains CRYSTAL CHARLOTTE KOSTELYK (ARNP)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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