Dan Ecclestone, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

102547 Issued in NC

Practice address

200 Wellesley Trade LN
Cary, NC 27519-5576

Phone

(919) 363-7546

Fax

(919) 363-3616

NPI assigned

Oct 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Practice roles

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.

• Pih Health Physicians

  • Family Medicine Physician
  • Whittier, CA
  • NPI 1588829006
  NPD (past)

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409270400000",
    "number": "1356424501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 WELLESLEY TRADE LN",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275195576",
            "telephone_number": "919-363-7546",
            "fax_number": "919-363-3616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 WELLESLEY TRADE LN",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275195576",
            "telephone_number": "919-363-7546",
            "fax_number": "919-363-3616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECCLESTONE",
        "first_name": "DAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2014-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "102547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "198486",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• E Scott Saltzman DMD PA
• Annette Hopkins Eaton, PT
• Lee Cole Eaton, DPT
• Walter Ebile Akoh, PHARMD
• Richard Ebken
• Jason James Eckel, M.D.
• Luting Eckensweiler, DO
• Eckerd Corporation
• Eckerd Corporation
• Eckerd Corporation

• Physician Assistant in Cary, NC
• Providers in Cary, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2014; 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.