Ellyssa Susan Degroot, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA059299 Issued in PA

Practice address

1240 S Cedar Crest Blvd Ste 403
Allentown, PA 18103-6218

Phone

(610) 402-3650

NPI assigned

Sep 28, 2017

Last updated

Sep 28, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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, NJ2 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

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clinical Health Care Associates of New Jersey PCGroup PAC ID 0749180198, 793 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University Medical Center of Princeton at Plainsboro Hospital, Plainsboro, NJ, CCN 310010

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Clinical Health Care Associates of New Jersey, P.C.

  • Family Medicine Physician
  • Cherry Hill, NJ
  • NPI 1447260435
  Medicare reassignment Care Compare group NPD
• Lehigh Valley Physician Group

  dba LVPG Developmental Pediatrics

  • Developmental - Behavioral Pediatrics Physician
  • Allentown, PA
  • NPI 1780155689
  Medicare reassignment
• Princeton Healthcare Affiliated Physicians PC

  dba Princeton HealthCare Medical Associates

  • Internal Medicine Physician
  • Plainsboro, NJ
  • NPI 1518194323
  Medicare reassignment
• Lehigh Valley Physician Group

  dba LVPG Family and Internal Medicine - East Stroudsburg

  • Family Medicine Physician
  • East Stroudsburg, PA
  • NPI 1245093368
  NPD
• Lehigh Valley Physician Group

  dba LVPG Internal Medicine - Orwigsburg

  • Family Medicine Physician
  • Schuylkill Haven, PA
  • NPI 1679335061
  NPD
• Clinical Health Care Associates of New Jersey, PC

  • Internal Medicine Physician
  • Cherry Hill, NJ
  • NPI 1134278971
  NPD
• Princeton Healthcare Affiliated Physicians PC

  dba Montgomery Internal Medicine Group - Princeton Medicine

  • Internal Medicine Physician
  • Princeton, NJ
  • NPI 1770176372
  NPD
• Princeton Healthcare Affiliated Physicians PC

  dba Hamilton Medical Group - Princeton Medicine

  • Internal Medicine Physician
  • Hamilton Square, NJ
  • NPI 1891106498
  NPD
• Dept. of Med, C/O Carl O'Brien Dba Princeton Hosp. Medical Assocs.

  • Internal Medicine Physician
  • Princeton, NJ
  • NPI 1215957519
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Princeton Healthcare System, a New Jersey Non-Profit Corporation

  dba Penn Medicine Princeton Medical Center

  • General Acute Care Hospital
  • Plainsboro, NJ
  • NPI 1689714255
  Care Compare affiliation

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

{
    "created_epoch": "1506556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506556800000",
    "number": "1285143677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 S CEDAR CREST BLVD STE 403",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036218",
            "telephone_number": "610-402-3650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 S CEDAR CREST BLVD STE 403",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036218",
            "telephone_number": "610-402-3650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGROOT",
        "first_name": "ELLYSSA",
        "middle_name": "SUSAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-28",
        "last_updated": "2017-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA059299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Yvonne Defranco, BA
• Todd Defrees
• Renae N Defreitas, CRNP
• Joseph Defulvio, DO
• Amber Degezelle, PMHNP-BC
• Kelsey J Dehaven, MA, BCBA, LBS
• John Howard Dehoff, MD
• Lana Elizabeth Deist, CRNP
• Danielle Deitrick, DO
• Maricelly Dejesus

• Physician Assistant in Allentown, PA
• Providers in Allentown, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.