Individual provider Active NPI

Preethy Cyriac, PA

  • Physician Assistant
  • Newark, DE
National Provider Identifier
1205893773
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA051963 Issued in PA
Practice address
4755 Ogletown Stanton Road
Suite 5A43
Newark, DE 19718-2200
Phone
(302) 623-0188
Fax
(302) 733-5640
NPI assigned
Apr 28, 2006
Last updated
Sep 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C5-0012094 DE
Physician Assistant 363A00000X C0009539 MD
Physician Assistant 363A00000X MA051963 PA Primary

Addresses

Primary practice location

4755 Ogletown Stanton Road
Suite 5A43
Newark, DE 19718-2200

Mailing address

2300 Computer Rd
Suite H-39
Willow Grove, PA 19090-1752
Phone (215) 657-5200

Other practice location 1

2300 Computer Rd
suite H-39
Willow Grove, PA 19090-1752
Phone (215) 657-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, MD2 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
I20070110000302 PA Practitioner - Physician Assistant 0648270991 Reassigns benefits to 4 organizations
I20241010003778 MD Practitioner - Physician Assistant 0648270991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Philadelphia College of Osteopathic Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alignmed Medical Group PCGroup PAC ID 3476090440, 62 clinicians

Practice addresses (Care Compare)

225 Evergreen Rd
Pottstown, PA 19464-3143
Phone (610) 323-1800

227 Evergreen Rd
Pottstown, PA 19464-3143
Phone (610) 718-0900

3485 Davisville Rd
Hatboro, PA 19040-4220
Phone (215) 830-0400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA051963PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Union Hospital of Cecil County CurrentSince Oct 1, 2024 Accepting new patients
Abington Memorial Hospital CurrentSince Jan 1, 2017 Accepting new patients
Geps Physician Group of Pennsylvania PC CurrentSince Aug 8, 2023 Accepting new patients
Abington Memorial Hospital CurrentSince Jan 1, 2017 Accepting new patients

Locations

4755 Ogletown Stanton Rd
Ste 5A43
Newark, DE 19718
Phone (302) 623-0188

106 Bow St
Elkton, MD 21921
Phone (410) 298-2000

207 North St
Ste A
Elkton, MD 21921

1200 York Rd
Abington, PA 19001
Phone (215) 481-2222

549 Baltimore Pike
Glen Mills, PA 19342
Phone (610) 358-6005

3485 Davisville Rd
Hatboro, PA 19040
Phone (215) 830-0400

125 Medical Campus Dr
Ste 220
Lansdale, PA 19446
Phone (215) 517-1200

1718 Spring Creek Rd
Macungie, PA 18062
Phone (610) 366-0500

1194 Naamans Creek Rd
Marcus Hook, PA 19060
Phone (610) 358-6005

5501 Perkiomen Ave
Reading, PA 19606
Phone (610) 779-0600

800 W Miner St
West Chester, PA 19382
Phone (484) 920-6200

2300 Computer Rd
Ste H39
Willow Grove, PA 19090
Phone (215) 657-5200

1245 Church Rd
Wyncote, PA 19095
Phone (215) 884-9990

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.

NPI Registry JSON

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1205893773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 COMPUTER RD",
            "address_2": "SUITE H-39",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901752",
            "telephone_number": "215-657-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 OGLETOWN STANTON ROAD",
            "address_2": "SUITE 5A43",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197182200",
            "telephone_number": "302-623-0188",
            "fax_number": "302-733-5640"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 Computer Rd",
            "address_2": "suite H-39",
            "address_purpose": "LOCATION",
            "city": "Willow Grove",
            "state": "PA",
            "postal_code": "190901752",
            "country_code": "US",
            "telephone_number": "215-657-5200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CYRIAC",
        "first_name": "PREETHY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-28",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0012094",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0009539",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA051963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.