Adriana Distanislao, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA056368 Issued in PA

Practice address

1850 E Park Ave Ste 312
State College, PA 16803-6706

Phone

(814) 237-6600

Fax

(814) 237-5383

NPI assigned

Sep 23, 2013

Last updated

Jul 27, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Dermatology of Pennsylvania, PCGroup PAC ID 5799091690, 29 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

79.36 of 100Reported as group

Quality

83.84

Promoting interoperability

85

Improvement activities

40

Cost

59.85

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Advanced Dermatology of Pennsylvania, PC

  • Dermatology Physician
  • Philadelphia, PA
  • NPI 1740671767
  Medicare reassignment Care Compare group
• Milstein Dermatology LLC

  • Dermatology Physician
  • Norristown, PA
  • NPI 1801233358
  NPD (past)

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

{
    "created_epoch": "1379894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501113600000",
    "number": "1497181416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S 54TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191431900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 E PARK AVE STE 312",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036706",
            "telephone_number": "814-237-6600",
            "fax_number": "814-237-5383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISTANISLAO",
        "first_name": "ADRIANA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-23",
        "last_updated": "2017-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA056368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• DFP Counseling Services
• Pushkar Mayur Dhume
• Heather Ann Dick, LCSW
• Dicks Home Care Inc
• Dallis Dillon
• Lynn E Diven, RD LD CDE
• Courtney Dixon-Hudlow
• Richard H. Dixon, M.D.
• Stephanie Lynn Dixon, LSW, CPRP
• Suzanne E Dixon, CRNA

• Physician Assistant in State College, PA
• Providers in State College, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2017; 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.

Verify at the official NPI Registry.