Individual provider Active NPI

Cassandra Hope McKenna, PA-C

  • Physician Assistant
  • Wilmington, DE
National Provider Identifier
1265144810
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
701 N Clayton St
Wilmington, DE 19805-3155
Phone
(302) 421-4100
NPI assigned
Dec 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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 Primary
Physician Assistant 363A00000X C5-0011980 DE

Addresses

Primary practice location

701 N Clayton St
Wilmington, DE 19805-3155

Mailing address

629 N 36TH St
Philadelphia, PA 19104-1939
Phone (908) 698-1228

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20231101000251 DE Practitioner - Physician Assistant 9335595818 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C5-0011980DEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC CurrentSince Oct 22, 2025 Accepting new patients
Cep America LLC CurrentSince Oct 22, 2025 Accepting new patients
Atlantic Physician Services of Maryland, PC Physician Assistant CurrentSince Nov 1, 2023 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

701 N Clayton St
Wilmington, DE 19805
Phone (302) 421-4100

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1670976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1265144810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 N 36TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191041939",
            "telephone_number": "908-698-1228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N CLAYTON ST",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198053155",
            "telephone_number": "302-421-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENNA",
        "first_name": "CASSANDRA",
        "middle_name": "HOPE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-14",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0011980",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.