NPIMap

Individual provider Active NPI

Ellyn Gabrielle Dornseif, PA-C

  • Medical Physician Assistant
  • Fountain Hill, PA
National Provider Identifier
1144693284
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA057837 Issued in PA
Practice address
701 Ostrum St
Suite 603
Fountain Hill, PA 18015-1155
Phone
(484) 526-3990
Fax
(610) 868-2915
NPI assigned
Nov 12, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA057837 PA Primary
Surgical Physician Assistant 363AS0400X MA057837 PA
Physician Assistant 363A00000X MA057837 PA

Addresses

Primary practice location

701 Ostrum St
Suite 603
Fountain Hill, PA 18015-1155

Mailing address

701 Ostrum St Ste 603
Fountain Hill, PA 18015-1184
Phone (484) 526-3990

Other identifiers 2

IdentifierTypeStateIssuer
71812OtherPAMEDICARE
1007307530136MedicaidPA

Other names 1

  • Ellyn Gabrielle Yackanicz Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151208001647 PA Practitioner - Physician Assistant 8426358896 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians

Practice addresses (Care Compare)

701 Ostrum St
Fountain Hill, PA 18015-1152

801 Ostrm St
Bethlehem, PA 18015-1000

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Bethlehem, PA, CCN 390049
  • St Luke'S Miners Memorial Hospital Hospital, Coaldale, PA, CCN 390183
  • St Luke'S Hospital - Grand View Campus Hospital, Sellersville, PA, CCN 390057
  • St Luke'S Warren Hospital Hospital, Phillipsburg, NJ, CCN 310060

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA057837PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Physician Group Inc CurrentSince Nov 16, 2015 Accepting new patients
St. Luke'S Physician Group, Inc CurrentSince Nov 16, 2015 Accepting new patients
St. Luke'S Physician Group, Inc Past Accepting new patients

Locations

701 Ostrum St
Ste 603
Fountain Hill, PA 18015
Phone (484) 526-3990

701 Ostrum St
Ste 201
Fountain Hill, PA 18015
Phone (610) 868-1014

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

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.

Hospital & facility affiliations 9

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": "1447286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1144693284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 OSTRUM ST STE 603",
            "city": "FOUNTAIN HILL",
            "state": "PA",
            "postal_code": "180151184",
            "telephone_number": "484-526-3990",
            "fax_number": "610-868-2915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 OSTRUM ST",
            "address_2": "SUITE 603",
            "city": "FOUNTAIN HILL",
            "state": "PA",
            "postal_code": "180151155",
            "telephone_number": "484-526-3990",
            "fax_number": "610-868-2915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORNSEIF",
        "first_name": "ELLYN",
        "middle_name": "GABRIELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-12",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA057837",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA057837",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA057837",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "71812",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007307530136",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLYN",
            "last_name": "YACKANICZ",
            "middle_name": "GABRIELLE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fountain Hill, PA

Sources for this page

Verify at the official NPI Registry.