Ashley Lynn Disney, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

MA055914 Issued in PA

Practice address

181 Interstate Parkway
Bradford, PA 16701

Phone

(814) 362-4345

Fax

(814) 362-1178

NPI assigned

Sep 10, 2012

Last updated

Dec 18, 2012By 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

Other names 1

• Miss Ashley Lynn Eliason Former name

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• General Physician, PC

  • General Practice Physician
  • Dunkirk, NY
  • NPI 1093959322
  Medicare reassignment

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

{
    "created_epoch": "1347235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355788800000",
    "number": "1285983973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 INTERSTATE PARKWAY",
            "city": "BRADFORD",
            "state": "PA",
            "postal_code": "16701",
            "telephone_number": "814-362-4345",
            "fax_number": "814-362-1178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 INTERSTATE PARKWAY",
            "city": "BRADFORD",
            "state": "PA",
            "postal_code": "16701",
            "telephone_number": "814-362-4345",
            "fax_number": "814-362-1178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISNEY",
        "first_name": "ASHLEY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-10",
        "last_updated": "2012-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA055914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "ELIASON",
            "middle_name": "LYNN",
            "prefix": "MISS",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Darling Apothecary, LLC (The Pharmacy at Union Square)
• Andrew Davidson, CRNP
• Donald Jack Deforno Jr., M.D.
• Frank James Denig, MSG000094
• Wendy Lynne Dennis, PA-C
• Kimberly Ann Ditz, CRNP
• Dr Peter Vaccaro MD Osm
• Dr Peter Vaccaro MD Osm
• Dr. Edward P Epstein DPM
• Victoria Lynn Durlin, RPH

• Surgical Physician Assistant in Bradford, PA
• Providers in Bradford, PA by specialty
• Surgical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.