Amber Brooke Lallo, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA061099 Issued in PA

Practice address

825 Old Lancaster Rd Ste 350
Bryn Mawr, PA 19010-3238

Phone

(610) 527-8118

Fax

(610) 527-3296

NPI assigned

Oct 14, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA, FL2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Bryn Mawr Medical Specialists Association

  • Multi-Specialty Clinic/Center
  • Bryn Mawr, PA
  • NPI 1841226099
  Medicare reassignment NPD
• Florida Clinical Practice Association Inc

  • Surgery Physician
  • Gainesville, FL
  • NPI 1063463768
  Medicare reassignment NPD
• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643
  Medicare reassignment
• Simedhealth LLC

  • Internal Medicine Physician
  • Gainesville, FL
  • NPI 1639680127
  Medicare reassignment
• Florida Clinical Practice Association Inc

  • Durable Medical Equipment & Medical Supplies
  • Ocala, FL
  • NPI 1609529478
  NPD
• Simed Health LLC

  • Community/Retail Pharmacy
  • Gainesville, FL
  • NPI 1376616698
  NPD

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

{
    "created_epoch": "1571011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1013559871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 OLD LANCASTER RD STE 320",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103235",
            "telephone_number": "610-527-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 OLD LANCASTER RD STE 350",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103238",
            "telephone_number": "610-527-8118",
            "fax_number": "610-527-3296"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326103121",
            "country_code": "US",
            "telephone_number": "352-273-9804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LALLO",
        "first_name": "AMBER",
        "middle_name": "BROOKE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-14",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA061099",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9113918",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jillian Kurtz
• Andrew Kwak, MD
• Diane M. Lagomarsino, CRNP
• Cheryl A Laing, EFDA
• Tara Lal
• Quynhdiem Thi Lam
• Wai Hei Lam, MD
• Elena Paulus Lamb
• Annamarie Lammendola-Melone, DO
• Thomas F Lanchoney, MD

• Physician Assistant in Bryn Mawr, PA
• Providers in Bryn Mawr, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.