NPIMap

Individual provider Active NPI

Alicia Frances Renna, PA-C

  • Medical Physician Assistant
  • Coatesville, PA
National Provider Identifier
1487913828
Registry record updated Apr 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA055477 Issued in PA
Practice address
217 Reeceville Rd Ste C
Coatesville, PA 19320-1572
Phone
(610) 384-6076
NPI assigned
May 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA055477 PA Primary

Addresses

Primary practice location

217 Reeceville Rd Ste C
Coatesville, PA 19320-1572

Mailing address

405 S Newtown Street Rd
Newtown Square, PA 19073-4411
Phone (845) 417-7770

Other identifiers 1

IdentifierTypeStateIssuer
1034580900001MedicaidPA

Other names 1

  • Alicia Frances Wise Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121121000136 PA Practitioner - Physician Assistant 3375794308 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regional Gastroenterology Associates of Lancaster, LTD.Group PAC ID 4688575434, 248 clinicians

Practice addresses (Care Compare)

1011 Reed Ave
Suite 300
Wyomissing, PA 19610-2002
Phone (610) 374-4401

2112 Harrisburg Pike
Suite 202
Lancaster, PA 17601-2644
Phone (717) 869-4600

Hospital & facility affiliations

  • Chester County Hospital Hospital, West Chester, PA, CCN 390179
  • Paoli Hospital Hospital, Paoli, PA, CCN 390153
  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111
  • Lancaster General Hospital Hospital, Lancaster, PA, CCN 390100
  • Reading Hospital Hospital, West Reading, PA, CCN 390044

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Geps Physician Group of Pennsylvania, PC CurrentSince Feb 10, 2014 Accepting new patients
Midatlantic Endoscopy LLC Current Accepting new patients
Regional Gastroenterology Associates of Lancaster, LTD. CurrentSince Jul 1, 2019 Accepting new patients
Jefferson University Physicians Past Accepting new patients

Locations

217 Reeceville Rd
Ste C
Coatesville, PA 19320
Phone (610) 374-4401

2112 Harrisburg Pike
Ste 202
Lancaster, PA 17601
Phone (717) 544-3500

1194 Naamans Creek Rd
Marcus Hook, PA 19060
Phone (610) 358-6005

475 Enterprise Dr
Ste 202
Royersford, PA 19468
Phone (610) 674-4401

1011 Reed Ave
Ste 300
Wyomissing, PA 19610
Phone (610) 374-4401

Interoperability endpoints

  • Direct secure messaging: aliciawise@ddal.allscriptsdirect.net
  • Direct secure messaging: awise170@yourcarecommunity.org

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1336089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555286400000",
    "number": "1487913828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 S NEWTOWN STREET RD",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190734411",
            "telephone_number": "845-417-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 REECEVILLE RD STE C",
            "city": "COATESVILLE",
            "state": "PA",
            "postal_code": "193201572",
            "telephone_number": "610-384-6076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENNA",
        "first_name": "ALICIA",
        "middle_name": "FRANCES",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-04",
        "last_updated": "2019-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA055477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1034580900001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICIA",
            "last_name": "WISE",
            "middle_name": "FRANCES",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Coatesville, PA

Sources for this page

Verify at the official NPI Registry.