Fafa Tsikata, ATC

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

RT005186 Issued in PA

Practice address

428 Orchard Ave
Yeadon, PA 19050-3114

Phone

(484) 343-0260

NPI assigned

May 16, 2017

Last updated

May 16, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1494892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494892800000",
    "number": "1285161604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 N FRONT ST",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "178371507",
            "telephone_number": "484-343-0260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 ORCHARD AVE",
            "city": "YEADON",
            "state": "PA",
            "postal_code": "190503114",
            "telephone_number": "484-343-0260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSIKATA",
        "first_name": "FAFA",
        "name_prefix": "Miss",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-16",
        "last_updated": "2017-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "PA",
            "license": "RT005186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF CERTIFICATION",
            "identifier": "200005221",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENNSYLVANIA BOARD OF MEDICINE",
            "identifier": "RT005186",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Sports Medicine (Family Medicine) Physician in Yeadon, PA
• Providers in Yeadon, PA by specialty
• Sports Medicine (Family Medicine) Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.