Individual provider Active NPI

Casey Elizabeth Reid, PA-C

  • Medical Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1669104154
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA063893 Issued in PA
Practice address
2310 E Allegheny Ave
Philadelphia, PA 19134-4401
Phone
(215) 427-1111
NPI assigned
Jun 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Medical Physician Assistant 363AM0700X MA063893 PA Primary

Addresses

Primary practice location

2310 E Allegheny Ave
Philadelphia, PA 19134-4401

Mailing address

823 Sunnyside Ave
Audubon, PA 19403-1822
Phone (610) 312-6354

Other practice location 1

4170 City Ave
Philadelphia, PA 19131-1610
Phone (215) 871-6100

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
I20230308001702 PA Practitioner - Physician Assistant 3971976192 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pennsylvania Dermatology Partners IncGroup PAC ID 3274794268, 75 clinicians

Practice addresses (Care Compare)

1950 St Rd
Suite 100
Bensalem, PA 19020-3749
Phone (215) 639-7546

2310 E Allegheny Ave
Philadelphia, PA 19134-4401
Phone (215) 427-1111

Merit-based Incentive Payment System (MIPS)

Final score
89.52 of 100Reported as group
Quality
87.67
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mitchell a Anolik MD PC CurrentSince Dec 13, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: creid@pennderm.emadirect.md

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.

NPI Registry JSON

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

{
    "created_epoch": "1656028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1669104154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 SUNNYSIDE AVE",
            "city": "AUDUBON",
            "state": "PA",
            "postal_code": "194031822",
            "telephone_number": "610-312-6354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 E ALLEGHENY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191344401",
            "telephone_number": "215-427-1111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4170 City Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191311610",
            "country_code": "US",
            "telephone_number": "215-871-6100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REID",
        "first_name": "CASEY",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-24",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA063893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.