Individual provider Active NPI

Daniel Scott Telega, PA-C

  • Physician Assistant
  • Erie, PA
National Provider Identifier
1669719720
Registry record updated Jan 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
OA000305L Issued in PA
Practice address
2910 State Street
Erie, PA 16508-4747
Phone
(814) 454-5686
NPI assigned
Jan 9, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2017

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 OA000305L PA Primary
Physician Assistant 363A00000X MA002307L PA

Addresses

Primary practice location

2910 State Street
Erie, PA 16508-4747

Mailing address

2185 W 8TH St
Erie, PA 16505-4747
Phone (888) 453-5806

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
I20170703000653 PA Practitioner - Physician Assistant 4688943806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stairways Behavioral HealthGroup PAC ID 0143117697, 16 clinicians

Practice addresses (Care Compare)

2910 State St
Erie, PA 16508-1832
Phone (814) 464-8311

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA002307LPAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Stairways Behavioral Health Physician Assistant CurrentSince Apr 18, 2017 Accepting new patients

Locations

2910 State St
Erie, PA 16508
Phone (814) 454-5686

2185 W 8th St
Erie, PA 16505
Phone (814) 464-8311

Organizations & group practices 1

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": "1357689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484697600000",
    "number": "1669719720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2185 W 8TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165054747",
            "telephone_number": "888-453-5806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 STATE STREET",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165084747",
            "telephone_number": "814-454-5686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELEGA",
        "first_name": "DANIEL",
        "middle_name": "SCOTT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-09",
        "last_updated": "2017-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA000305L",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA002307L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.