Individual provider Active NPI

Diana Casallas, PA-C

  • Physician Assistant
  • Abington, PA
National Provider Identifier
1295107589
Registry record updated Apr 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA061167 Issued in PA
Practice address
1200 Old York Rd Ste 2B
Abington, PA 19001-3720
Phone
(215) 481-2222
Fax
(215) 481-4361
NPI assigned
Oct 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2020

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 C0005968 MD
Physician Assistant 363A00000X MA061167 PA Primary

Addresses

Primary practice location

1200 Old York Rd Ste 2B
Abington, PA 19001-3720

Mailing address

2500 Maryland Rd Ste 400
Willow Grove, PA 19090-1225
Phone (215) 481-4141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20200203001440 PA Practitioner - Physician Assistant 8921309857 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

777 Township Line Rd
Suite 200
Yardley, PA 19067-5564
Phone (215) 860-0775

824 Main St
Phoenixville, PA 19460-4478

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C0005968MDMDPhysician Assistant
MA061167PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group CurrentSince Dec 23, 2019 Accepting new patients
Abington Memorial Hospital CurrentSince Oct 1, 2020 Accepting new patients
Abington Memorial Hospital CurrentSince Oct 1, 2020 Accepting new patients
University of Penn-Medical Group CurrentSince Dec 23, 2019 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Apr 28, 2024 Accepting new patients

Locations

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

1200 Old York Rd
Ste 2B
Abington, PA 19001
Phone (215) 481-2222

2500 Maryland Rd
Ste 400
Willow Grove, PA 19090
Phone (215) 481-3915

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1445817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586995200000",
    "number": "1295107589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 MARYLAND RD STE 400",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901225",
            "telephone_number": "215-481-4141",
            "fax_number": "215-481-6790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 OLD YORK RD STE 2B",
            "city": "ABINGTON",
            "state": "PA",
            "postal_code": "190013720",
            "telephone_number": "215-481-2222",
            "fax_number": "215-481-4361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASALLAS",
        "first_name": "DIANA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-26",
        "last_updated": "2020-04-16",
        "certification_date": "2020-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0005968",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA061167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abington, PA

Sources for this page

Verify at the official NPI Registry.