Individual provider Active NPI

Dawn Barilli, RPA-C

  • Physician Assistant
  • Monroe, NY
National Provider Identifier
1295732196
Registry record updated Jan 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0067671 Issued in NY
Practice address
503 Route 208
Monroe, NY 10950-1619
Phone
(845) 783-2920
NPI assigned
Jul 7, 2005
Reactivated
Oct 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0067671 NY Primary

Addresses

Primary practice location

503 Route 208
Monroe, NY 10950-1619

Mailing address

503 Route 208
Monroe, NY 10950-1619
Phone (845) 783-2920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0067671NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orange Dermatology Associates, PC CurrentSince Apr 8, 1990 Accepting new patients

Locations

503 State Route 208
Monroe, NY 10950
Phone (845) 783-2920

Organizations & group practices 1

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359504000000",
    "number": "1295732196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 ROUTE 208",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109501619",
            "telephone_number": "845-783-2920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 ROUTE 208",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109501619",
            "telephone_number": "845-783-2920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARILLI",
        "first_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2013-01-30",
        "deactivation_date": "2006-03-21",
        "reactivation_date": "2007-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "0067671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2013; 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.