ELLYSSA SUSAN DEGROOT (NPI# 1285143677) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285143677 |
| Entity Type | Individual |
| Full Name | ELLYSSA SUSAN DEGROOT |
| Credential | PA-C |
| Practice Address |
1240 S Cedar Crest Blvd Ste 403 Allentown PA 18103-6218 |
| Practice Telephone | 6104023650 |
| Mailing Telephone | 6104023650 |
| Enumeration Date | 2017-09-28 |
| Last Update Date | 2017-09-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | MA059299 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1240 S CEDAR CREST BLVD STE 403 |
| City | ALLENTOWN |
| State | PA |
| Zip Code | 18103-6218 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376156752 | Syed Ali Aown | Internal Medicine | 1200 Cedar Crest Blvd Department of Education-office Of, Allentown, PA 18103 | 2020-08-26 |
| 1558980169 | Shelley M. Spence | Occupational Therapist | 1243 South Cc Blvd., Suite 302, Allentown, PA 18103 | 2020-04-14 |
| 1386133791 | Hanger Prosthetics & Orthotics East Inc | Durable Medical Equipment & Medical Supplies | 1259 S Cedar Crest Blvd Ste 336, Allentown, PA 18103 | 2018-05-02 |
| 1366939555 | St. Luke's Physician Group, Inc. | Family Medicine | 3570 Hamilton Blvd Ste 201, Allentown, PA 18103 | 2018-04-13 |
| 1942701008 | Bradford Young Family & Cosmetic Dentistry | Dentist | 1275 S. Cedar Crest Boulevard, Allentown, PA 18103 | 2018-02-23 |
| 1598275281 | Lorillie Soleta | Nurse Practitioner | Good Shepherd Rehabilitation Network, 850 South 5th St., Allentown, PA 18103 | 2017-10-06 |
| 1538681457 | Rahul Gupta | Internal Medicine | Lehigh Valley Physicians Practice, 1250 S. Cedar Crest Blvd, Ste. 300, Allentown, PA 18103 | 2017-07-12 |
| 1669992962 | Aaron Michael Roman | Audiologist | 1210 S. Cedar Crest Blvd., Allentown, PA 18103 | 2017-06-27 |
| 1134658404 | Gyujae Choi | Internal Medicine | 1200 S. Cedar Crest Blvd., Allentown, PA 18103 | 2017-06-08 |
| 1255713731 | Firely Home for Kids | Skilled Nursing Facility | 2402 Sunshine Rd, Allentown, PA 18103 | 2015-06-22 |
| Find all providers in zip 18103 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972110658 | Michael Giacoumopoulos | Physician Assistant | 3131 College Heights Blvd Ste 2200, Allentown, PA 18104-4877 | 2020-09-28 |
| 1679826036 | Adam Robert Ternosky | Physician Assistant | 1101 South Cedar Crest Blvd., Allentown, PA 18103-7902 | 2012-10-23 |
| 1376892505 | Melissa Nicole Shaner | Physician Assistant | 1611 Pond Rd Ste 301, Allentown, PA 18104-2258 | 2012-09-04 |
| 1356690697 | Meghan Lynn Williams | Physician Assistant | 1255 S. Cedar Crest Blvd, Suite 2200, Allentown, PA 18103-6226 | 2012-08-31 |
| 1144539578 | Samantha Michael Evans | Physician Assistant | 1627 Chew Street, 101, Allentown, PA 18105-7017 | 2010-10-04 |
| 1497087597 | Susan R Adkins | Physician Assistant | 227 Pennsylvania 100, Allentown, PA 18106 | 2010-02-01 |
| 1447586276 | Tiffany Ann Burke | Physician Assistant | 3050 Hamilton Blvd. Ste 105, Allentown, PA 18103 | 2009-10-29 |
| 1063554988 | Carolyn Gaffney | Physician Assistant | 17th St. and Chew St., Allentown, PA 18105 | 2007-02-14 |
| 1376572545 | Amanda Lieberman | Physician Assistant | 1255 S Cedar Crest Blvd Ste 3600, Medical Imaging of Lehigh Valley, P.C., Allentown, PA 18103-6364 | 2006-07-01 |
| 1902858202 | Keith A. Holdren | Physician Assistant | 838 N Leh St, Allentown, PA 18104-3922 | 2006-05-16 |
| Find all providers in ALLENTOWN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.