Individual provider Active NPI

Alexis Rose Vavala

  • Physician Assistant
  • Warren, PA
National Provider Identifier
1003416165
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1885 Market St
Warren, PA 16365-1277
Phone
(814) 723-1832
NPI assigned
Oct 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1885 Market St
Warren, PA 16365-1277

Mailing address

1885 Market St
Warren, PA 16365-1277
Phone (814) 723-1832

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201125001792 PA Practitioner - Physician Assistant 0042621955 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1000 Dutch Ridge Rd
Beaver, PA 15009-9727
Phone (724) 773-6403

500 Sharon Rd
Beaver, PA 15009-1957
Phone (724) 728-8751

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Center for Treatment and Education CurrentSince Sep 28, 2020 Accepting new patients

Locations

1885 Market St
Warren, PA 16365
Phone (814) 723-1832

Interoperability endpoints

  • Direct secure messaging: alexisvavala@hvhs.allscriptsdirect.net
  • FHIR API: https://fhirtw.hvhs.org/R4/open-R4

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1603843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1003416165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1885 MARKET ST",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163651277",
            "telephone_number": "814-723-1832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1885 MARKET ST",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163651277",
            "telephone_number": "814-723-1832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAVALA",
        "first_name": "ALEXIS",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-28",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, PA

Sources for this page

Verify at the official NPI Registry.