Individual provider Active NPI

Amy Chrisopi Large

  • Physician Assistant
  • Newark, DE
National Provider Identifier
1659974517
Registry record updated Nov 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C5-0011588 Issued in DE
Practice address
4755 Ogletown Stanton Rd
Newark, DE 19718-1303
Phone
(302) 733-1000
NPI assigned
Nov 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2021

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 MA062717 PA
Physician Assistant 363A00000X C5-0011588 DE Primary

Addresses

Primary practice location

4755 Ogletown Stanton Rd
Newark, DE 19718-1303

Mailing address

815 Lisadell Dr
Kennett Square, PA 19348-1303
Phone (610) 742-8094

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20211108002085 DE Practitioner - Physician Assistant 1052700382 Reassigns benefits to 1 organization
I20250911003026 PA Practitioner - Physician Assistant 1052700382 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christiana Care Health Services IncGroup PAC ID 9739097569, 1,480 clinicians

Practice addresses (Care Compare)

4755 Ogletown Stanton Rd
Newark, DE 19718-2200
Phone (302) 733-5982

774 Christiana Rd
Suite 201
Newark, DE 19713-4221
Phone (302) 623-3017

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA062717PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince Sep 8, 2025 Accepting new patients
Christiana Care Health Services Inc CurrentSince Nov 2, 2021 Accepting new patients
University of Penn - Medical Group CurrentSince Sep 8, 2025 Accepting new patients
Christiana Care Health Services Inc CurrentSince Nov 2, 2021 Accepting new patients

Locations

774 Christiana Rd
Ste 201
Newark, DE 19713
Phone (302) 623-3017

4755 Ogletown Stanton Rd
Ste 2E99
Newark, DE 19718
Phone (302) 623-3017

4755 Ogletown Stanton Rd
Newark, DE 19718
Phone (302) 733-1700

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1659974517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 LISADELL DR",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193481303",
            "telephone_number": "610-742-8094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 OGLETOWN STANTON RD",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197181303",
            "telephone_number": "302-733-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARGE",
        "first_name": "AMY",
        "middle_name": "CHRISOPI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-20",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA062717",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0011588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.