Individual provider Active NPI

Diane Carol McAvoy, PA-C

  • Medical Physician Assistant
  • Salisbury, MD
National Provider Identifier
1083609002
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
C0007548 Issued in MD
Practice address
220 Tilghman Rd
Salisbury, MD 21804-1921
Phone
(410) 219-5530
NPI assigned
Sep 15, 2005
Last updated
Jun 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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 085009493 IL
Physician Assistant 363A00000X MA001866L PA
Medical Physician Assistant 363AM0700X 085.009493 IL
Medical Physician Assistant 363AM0700X C0007548 MD Primary

Addresses

Primary practice location

220 Tilghman Rd
Salisbury, MD 21804-1921

Mailing address

220 Tilghman Rd
Salisbury, MD 21804-1921
Phone (570) 592-5607

Other practice location 1

8741 Tatiana Dr Unit 102
Delmar, MD 21875-1821
Phone (570) 592-5607

Other identifiers 1

IdentifierTypeStateIssuer
1035418490002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, MD, DE3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20041015000175 PA Practitioner - Physician Assistant 4486614229 Reassigns benefits to 1 organization
I20240130001600 MD Practitioner - Physician Assistant 4486614229 Reassigns benefits to 2 organizations
I20240205002921 DE Practitioner - Physician Assistant 4486614229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ability Rehab AssociatesGroup PAC ID 4284699406, 9 clinicians

Practice addresses (Care Compare)

100 E Carroll St
Box 400
Salisbury, MD 21801-5422
Phone (410) 543-7065

220 Tilghman Rd
Salisbury, MD 21804-1921
Phone (410) 219-5530

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA001866LPAMDPhysician Assistant
085.009493ILMDMedical Physician Assistant
C0007548MDMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince May 14, 2018 Accepting new patients
Geisinger Clinic CurrentSince May 14, 2018 Accepting new patients
Damd, Inc Past Accepting new patients

Locations

2407 Reichart Rd
Bloomsburg, PA 17815
Phone (570) 784-6320

500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131

475 Morgan Hwy
Scranton, PA 18508
Phone (570) 344-3788

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CJFFCA/Endpoint/CJFFCA

Organizations & group practices 6

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

Hospital & facility affiliations 1

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": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1083609002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 TILGHMAN RD",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218041921",
            "telephone_number": "570-592-5607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 TILGHMAN RD",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218041921",
            "telephone_number": "410-219-5530"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8741 Tatiana Dr Unit 102",
            "address_purpose": "LOCATION",
            "city": "Delmar",
            "state": "MD",
            "postal_code": "218751821",
            "country_code": "US",
            "telephone_number": "570-592-5607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCAVOY",
        "first_name": "DIANE",
        "middle_name": "CAROL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-15",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085009493",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA001866L",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085.009493",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0007548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1035418490002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

Verify at the official NPI Registry.