Active NPI
Erin Giddens, PA-C
- Physician Assistant
- Vineland, NJ
National Provider Identifier
1417608993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 1102 E Chestnut Ave
Vineland, NJ 08360-5002 - Phone
- (856) 696-4484
- NPI assigned
- Jan 16, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
1102 E Chestnut Ave
Vineland, NJ 08360-5002
Mailing address
640 N Broad St Apt 631
Philadelphia, PA 19130-3420
Phone (407) 803-2018
Other names 1
- Erin Boncore
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2021
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
5380 Primrose Lake Cir
Tampa, FL 33647-3589
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Womans Group | Single Specialty | Past | Accepting new patients |
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Organizations & group practices 2
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.
-
- Obstetrics & Gynecology Physician
- Miami, FL
- NPI 1871572032
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642291200000",
"number": "1417608993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "640 N BROAD ST APT 631",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191303420",
"telephone_number": "407-803-2018"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1102 E CHESTNUT AVE",
"city": "VINELAND",
"state": "NJ",
"postal_code": "083605002",
"telephone_number": "856-696-4484"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIDDENS",
"first_name": "ERIN",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-01-16",
"last_updated": "2022-01-16",
"certification_date": "2022-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ERIN",
"last_name": "BONCORE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Vineland, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.