Individual provider Active NPI

Holly Buchanan, PA

  • Physician Assistant
  • Mandeville, LA
National Provider Identifier
1013457894
Registry record updated Feb 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2037 W Ridge Dr
Mandeville, LA 70448-1042
Phone
(610) 290-6039
NPI assigned
Feb 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2021

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

2037 W Ridge Dr
Mandeville, LA 70448-1042

Mailing address

2037 W Ridge Dr
Mandeville, LA 70448-1042
Phone (610) 290-6039

Other practice location 1

100 E Lancaster Ave
Wynnewood, PA 19096-3450
Phone (610) 290-6039

Other practice location 2

1 Capital Way
Pennington, NJ 08534-2520
Phone (609) 303-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210330000819 LA Practitioner - Physician Assistant 3779845094 Reassigns benefits to 3 organizations
I20230911002816 NY Practitioner - Physician Assistant 3779845094 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellnow Urgent Care, P.C.Group PAC ID 8325320864, 395 clinicians

Practice addresses (Care Compare)

1092 Route 222
Cortland, NY 13045-1831
Phone (607) 218-3708

7375 Oswego Rd
Suite 1
Liverpool, NY 13090-3717
Phone (315) 291-0064

740 S Main St
Ithaca, NY 14850-5377
Phone (607) 319-4563

830 County Rd
Suite 64
Elmira, NY 14903-9719
Phone (607) 846-2030

National Provider Directory

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

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1488240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1013457894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2037 W RIDGE DR",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704481042",
            "telephone_number": "610-290-6039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2037 W RIDGE DR",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704481042",
            "telephone_number": "610-290-6039"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 E Lancaster Ave",
            "address_purpose": "LOCATION",
            "city": "Wynnewood",
            "state": "PA",
            "postal_code": "190963450",
            "country_code": "US",
            "telephone_number": "610-290-6039",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Capital Way",
            "address_purpose": "LOCATION",
            "city": "Pennington",
            "state": "NJ",
            "postal_code": "085342520",
            "country_code": "US",
            "telephone_number": "609-303-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCHANAN",
        "first_name": "HOLLY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-28",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandeville, LA

Sources for this page

Verify at the official NPI Registry.