Individual provider Active NPI

Danielle L Becker, PA-C

  • Physician Assistant
  • Altoona, PA
National Provider Identifier
1194003038
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA054960 Issued in PA
Practice address
1101 Logan Blvd
Altoona, PA 16602-4029
Phone
(814) 943-9879
Fax
(814) 943-1808
NPI assigned
Jul 26, 2011
Last updated
Oct 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X OA002675 PA
Physician Assistant 363A00000X MA054960 PA Primary

Addresses

Primary practice location

1101 Logan Blvd
Altoona, PA 16602-4029

Mailing address

1101 Logan Blvd
Altoona, PA 16602-4029
Phone (814) 943-9879

Other identifiers 1

IdentifierTypeStateIssuer
1033595200001MedicaidPA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110823000149 PA Practitioner - Physician Assistant 1759551161 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Altoona Dermatology Associates IncGroup PAC ID 7113461864, 3 clinicians

Practice addresses (Care Compare)

1101 Logan Blvd
Altoona, PA 16602-4029
Phone 81494398791

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA054960PAMDPhysician Assistant
OA002675PAMDPhysician Assistant

Organizations & group practices 2

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 4

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": "1311638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1194003038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 LOGAN BLVD",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166024029",
            "telephone_number": "814-943-9879",
            "fax_number": "814-943-1808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 LOGAN BLVD",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166024029",
            "telephone_number": "814-943-9879",
            "fax_number": "814-943-1808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKER",
        "first_name": "DANIELLE",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-26",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA002675",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA054960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033595200001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Altoona, PA

Sources for this page

Verify at the official NPI Registry.