Individual provider Active NPI

Ava Elizabeth Powell, PA-C

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1457172819
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA066082 Issued in PA
Practice address
1 Convention Ave
Philadelphia, PA 19104-4311
Phone
(267) 862-3491
NPI assigned
Oct 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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 MA066082 PA Primary

Addresses

Primary practice location

1 Convention Ave
Philadelphia, PA 19104-4311

Mailing address

41 Broxton Way
Glassboro, NJ 08028-2928

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
I20250118000134 PA Practitioner - Physician Assistant 4981133030 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3400 Civic Ctr Blvd
Philadelphia, PA 19104-5127

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince Jan 6, 2025 Accepting new patients
University of Penn-Medical Group CurrentSince Jan 6, 2025 Accepting new patients

Locations

3400 Civic Center Blvd
#2
Philadelphia, PA 19104
Phone (215) 615-0063

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1729209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1457172819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 BROXTON WAY",
            "city": "GLASSBORO",
            "state": "NJ",
            "postal_code": "080282928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CONVENTION AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044311",
            "telephone_number": "267-862-3491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "AVA",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-18",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA066082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.