Individual provider Active NPI

Loretta A Connaughton, PA-C

  • Medical Physician Assistant
  • Ambler, PA
National Provider Identifier
1710213152
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA000501L Issued in PA
Practice address
722 E Butler Pike
Ambler, PA 19002-2310
Phone
(609) 890-1050
Fax
(609) 890-0950
NPI assigned
Oct 20, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA000501L PA Primary

Addresses

Primary practice location

722 E Butler Pike
Ambler, PA 19002-2310

Mailing address

722 E Butler Pike
Ambler, PA 19002-2310
Phone (215) 643-7800

Other identifiers 1

IdentifierTypeStateIssuer
MA000501LOtherPASTATE LICENSE

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
I20101216000916 PA Practitioner - Physician Assistant 2567650542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Pennsylvania Physician Alliance, LLCGroup PAC ID 8325478662, 112 clinicians

Practice addresses (Care Compare)

4641 Roosevelt Blvd
Philadelphia, PA 19124-2343
Phone (215) 831-4600

722 E Butler Pike
Ambler, PA 19002-2310
Phone (215) 643-7800

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
78.42
Improvement activities
40
Cost
70.24

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA000501LPAMDMedical Physician Assistant

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": "1255996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1710213152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 E BUTLER PIKE",
            "city": "AMBLER",
            "state": "PA",
            "postal_code": "190022310",
            "telephone_number": "215-643-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 E BUTLER PIKE",
            "city": "AMBLER",
            "state": "PA",
            "postal_code": "190022310",
            "telephone_number": "609-890-1050",
            "fax_number": "609-890-0950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNAUGHTON",
        "first_name": "LORETTA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-20",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA000501L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "MA000501L",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ambler, PA

Sources for this page

Verify at the official NPI Registry.