Individual provider Active NPI

Vanessa Resendiz, PA-C

  • Physician Assistant
  • Exton, PA
National Provider Identifier
1033698923
Registry record updated Apr 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
OA004537 Issued in PA
Practice address
278 Eagleview Blvd
Exton, PA 19341-1157
Phone
(610) 561-6400
Fax
(610) 561-6401
NPI assigned
Aug 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA059923 PA
Physician Assistant 363A00000X C5-0001294 DE
Physician Assistant 363A00000X MR4951681
Physician Assistant 363A00000X OA004537 PA Primary

Addresses

Primary practice location

278 Eagleview Blvd
Exton, PA 19341-1157

Mailing address

278 Eagleview Blvd
Exton, PA 19341-1157
Phone (610) 561-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, DE2 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
I20180907001335 PA Practitioner - Physician Assistant 0244580553 Reassigns benefits to 3 organizations
I20200212000167 DE Practitioner - Physician Assistant 0244580553

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C5-0001294DEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tower Health Medical Group Past Accepting new patients

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": "1533859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554336000000",
    "number": "1033698923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "278 EAGLEVIEW BLVD",
            "city": "EXTON",
            "state": "PA",
            "postal_code": "193411157",
            "telephone_number": "610-561-6400",
            "fax_number": "610-561-6401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "278 EAGLEVIEW BLVD",
            "city": "EXTON",
            "state": "PA",
            "postal_code": "193411157",
            "telephone_number": "610-561-6400",
            "fax_number": "610-561-6401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESENDIZ",
        "first_name": "VANESSA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-10",
        "last_updated": "2019-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA059923",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0001294",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": "MR4951681",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA004537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Exton, PA

Sources for this page

Verify at the official NPI Registry.