Dianna Elizabeth Vassallo, PA-C

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MA064802 Issued in PA

Practice address

130 S Bryn Mawr Ave # 203
Bryn Mawr, PA 19010-3121

Phone

(484) 337-3000

NPI assigned

Sep 25, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Main Line Emergency Med Associates LLC

  • Emergency Medicine Physician
  • Paoli, PA
  • NPI 1316919368
  Medicare reassignment
• Bayfront Emergency Physicians PA

  • Emergency Medicine Physician
  • Somers Point, NJ
  • NPI 1215998273
  NPD (past)

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

{
    "created_epoch": "1695600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1134908601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 CALDWELL CT",
            "city": "COLMAR",
            "state": "PA",
            "postal_code": "189153100",
            "telephone_number": "267-201-2102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S BRYN MAWR AVE # 203",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103121",
            "telephone_number": "484-337-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASSALLO",
        "first_name": "DIANNA",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-25",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MA064802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard M. Valenci, D.M.D.
• Courtney Valko, PA-C
• Tracy Van Der Zwan
• Robert B Vanderslice, MD
• Nancy Vanore, MSN, APRN, CS, RN
• Jessegnia A Velasquez, APRN
• Kathryn Verlinghieri, CRNP
• Joseph V Vernace, MD
• Vladimir Vetkin, CRNP
• Anastasiya Viarouka, CRNP

• Emergency Medicine Physician in Bryn Mawr, PA
• Providers in Bryn Mawr, PA by specialty
• Emergency Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.