MR. JODY JAMES DECASTRO (NPI# 1457633943) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457633943 |
| Entity Type | Individual |
| Full Name | MR. JODY JAMES DECASTRO |
| Credential | PA-C |
| Practice Address |
1910 Sassafras St Ste 300 Erie PA 16502-2716 |
| Practice Telephone | 8144527575 |
| Practice Fax Number | 8144527574 |
| Mailing Telephone | 8144527575 |
| Mailing Fax Number | 8144527574 |
| Enumeration Date | 2011-09-12 |
| Last Update Date | 2019-02-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
MA055017 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
015034 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CAQH | 12292814 | 01 |
| Street Address |
1910 SASSAFRAS ST STE 300 |
| City | ERIE |
| State | PA |
| Zip Code | 16502-2716 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417994682 | Rodney S. Bingham | Anesthesiology | 1910 Sassafras St Ste 300, Erie, PA 16502-2716 | 2006-05-31 |
| 1528497948 | Derrick Andrew Dupre | Neurological Surgery | 1910 Sassafras St Ste 300, Erie, PA 16502 | 2013-11-06 |
| 1104267830 | Feno M Monaco | Anesthesiology | 1910 Sassafras St Ste 300, Erie, PA 16502-2716 | 2013-07-10 |
| 1255691820 | Theodore Gary Eckman | Anesthesiology | 1910 Sassafras St Ste 300, Erie, PA 16502-2716 | 2012-05-17 |
| 1760761654 | Matthew A Depaul | Nurse Practitioner | 1910 Sassafras St Ste 300, Erie, PA 16502-2716 | 2011-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679064794 | Fernando Torres | Specialist/Technologist | 549 1/2 W 7th St, Erie, PA 16502 | 2018-05-24 |
| 1548782907 | Michael Wayne Hankins Jr. | Podiatrist | 5515 Peach Street, Erie, PA 16502 | 2017-07-07 |
| 1730609041 | Michael Greg Palmer | Family Medicine | 311 West 24th Street 4th Floor, Erie, PA 16502 | 2017-06-27 |
| 1245658723 | Amy Adamus | Licensed Practical Nurse | 1647 Sassafras Street, Erie, PA 16502 | 2014-04-02 |
| 1295011088 | Margaret Gay Wardd | Licensed Practical Nurse | 1757 West 23 Street, Erie, PA 16502 | 2011-10-25 |
| 1659510782 | Kristen Kathleen Curry | Social Worker | 329 W. 10th St., Erie, PA 16502 | 2009-02-12 |
| 1699928416 | Kelly Cathleen Kelly-zazado | Social Worker | 301 W. 10th St., Lake Erie Counseling, Inc, Erie, PA 16502 | 2008-10-23 |
| 1922149350 | Wei-lung Sam Wu | Internal Medicine | Saint Vincent Professional Building, 311 West 24 Street, Suite 402, Erie, PA 16502 | 2007-02-09 |
| 1003970146 | Claire Donch | Psychologist | 301 West 10th Street, Erie, PA 16502 | 2006-12-21 |
| 1730703117 | Vincent Viet Ngo | Family Medicine | 311 West 24th Street, 4th Floor, Erie, PA 16502 | 2020-06-02 |
| Find all providers in zip 16502 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306496872 | Maureen Grady | Physician Assistant | 240 West 11th Street, Suite 2, Erie, PA 16501 | 2019-09-17 |
| 1174920193 | Shelly A. Respecki | Physician Assistant | 120 E Second St 3rd Floor, Erie, PA 16507-1578 | 2014-11-20 |
| 1801105127 | Diane Marie Corey | Physician Assistant | 2620 Sigsbee St, Erie, PA 16508-1721 | 2010-10-04 |
| 1124124318 | Tamara J. Murphy | Physician Assistant | 100 Peach Street, Suite 200, Bayfront Digestive Disease, Erie, PA 16507-1423 | 2006-09-15 |
| 1508472622 | Liam Cunningham | Physician Assistant | 2374 Village Common Dr Ste 100, Erie, PA 16506-7201 | 2020-09-23 |
| 1679181093 | Micaela M Lippert | Physician Assistant | 333 State St Ste 104, Erie, PA 16507-1463 | 2020-07-22 |
| 1255971222 | Emina Vakufac | Physician Assistant | 2202 W 15th St, Erie, PA 16505-4510 | 2020-01-08 |
| 1679118269 | Alexandra Marie Hartman | Physician Assistant | 232 W 25th St, Erie, PA 16544-0002 | 2019-11-07 |
| 1982254173 | Erin Elizabeth Lipnicky | Physician Assistant | 118 E 2nd St, Erie, PA 16507-1502 | 2019-09-19 |
| 1841756483 | Justine M Koehler | Physician Assistant | 2315 Myrtle St Ste 190, Erie, PA 16502-4604 | 2019-02-19 |
| Find all providers in ERIE | ||||
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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.