Individual provider Active NPI

Sydney Marie Rausa, PA-C

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1649082967
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA066442 Issued in PA
Practice address
561 Fairthorne Ave
Philadelphia, PA 19128-2412
Phone
(215) 487-4000
NPI assigned
Jan 23, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X OA007185 PA
Physician Assistant 363A00000X MA066442 PA Primary

Addresses

Primary practice location

561 Fairthorne Ave
Philadelphia, PA 19128-2412

Mailing address

1382 Jasper Dr
Ambler, PA 19002-1010
Phone (267) 328-7790

Other practice location 1

1991 Sproul Rd Ste 230
Broomall, PA 19008-3518
Phone (610) 449-1525

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
I20250310000982 PA Practitioner - Physician Assistant 1254852015 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Drexel University College of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Gastroenterology Associates of Lancaster, LTD.Group PAC ID 4688575434, 248 clinicians

Practice addresses (Care Compare)

100 E Lancaster Ave
Suite 252
Wynnewood, PA 19096-3432
Phone (610) 896-7360

1088 W Baltimore Pike HCC II
2 Main Line Gastroenterology Associates PC
Media, PA 19063-5136
Phone (610) 565-1808

1991 Sproul Rd
Suite 230
Broomall, PA 19008-3518
Phone (610) 644-6755

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA066442PAMDPhysician Assistant
OA007185PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Gastroenterology Associates of Lancaster, LTD. CurrentSince May 1, 2025 Accepting new patients
Main Line Gastroenterology Associates, PC Past Accepting new patients

Locations

1991 Sproul Rd
Ste 230
Broomall, PA 19008
Phone (610) 449-1525

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

650 Carnegie Blvd
Ste 100
Malvern, PA 19355

1088 W Baltimore Pike
Ste 2407
Media, PA 19063
Phone (610) 521-2008

100 E Lancaster Ave
Ste 252
Wynnewood, PA 19096
Phone (610) 896-7360

Organizations & group practices 4

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 3

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": "1737590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1649082967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1382 JASPER DR",
            "city": "AMBLER",
            "state": "PA",
            "postal_code": "190021010",
            "telephone_number": "267-328-7790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "561 FAIRTHORNE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191282412",
            "telephone_number": "215-487-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1991 Sproul Rd Ste 230",
            "address_purpose": "LOCATION",
            "city": "Broomall",
            "state": "PA",
            "postal_code": "190083518",
            "country_code": "US",
            "telephone_number": "610-449-1525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAUSA",
        "first_name": "SYDNEY",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-23",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA007185",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA066442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.