NPIMap

Individual provider Active NPI

Diedra Elena Amendola McCafferty, D.O.

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1720211196
Registry record updated Apr 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS016486 Issued in PA
Practice address
800 Washington Ave
Philadelphia, PA 19147-4717
Phone
(215) 339-5100
Fax
(215) 454-6814
NPI assigned
Sep 1, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X UO 2270 FL
Family Medicine Physician 207Q00000X OS016486 PA Primary

Addresses

Primary practice location

800 Washington Ave
Philadelphia, PA 19147-4717

Mailing address

432 N 6TH St
Philadelphia, PA 19123-4004
Phone (215) 925-2400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20131112001659 PA Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 8820247208 Reassigns benefits to 2 organizations
I20240813002963 NJ Practitioner - Family Practice 8820247208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
Philadelphia College of Osteopathic Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gslpg, IncGroup PAC ID 7810226875, 269 clinicians
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians

Practice addresses (Care Compare)

100 Paramount Blvd
Orwigsburg, PA 17961-2202
Phone (484) 526-2440

100 St Lukes LN
Stroudsburg, PA 18360-6217
Phone (484) 526-2200

100 St Lukes Way
Stroudsburg, PA 18360-6217
Phone (272) 212-1000

1021 Park Ave
Quakertown, PA 18951-0130

1050 Main St
Hellertown, PA 18055-1538
Phone (610) 748-8888

185 Roseberry St
Phillipsburg, NJ 08865-1690
Phone (908) 847-3212

1872 St Lukes Blvd
Easton, PA 18045-5669
Phone (484) 526-7800

421 Chew St
Allentown, PA 18102-3406
Phone (484) 503-1018

421 W Chew St
Allentown, PA 18102-3406
Phone (610) 776-4959

700 Lawn Ave
Sellersville, PA 18960-1548
Phone (484) 822-5700

801 Ostrm St
Bethlehem, PA 18015-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue545
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
UO 2270FLMDFamily Medicine Physician
OS016486PAMDFamily Medicine Physician
252109MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Physician Group Inc Family Medicine CurrentSince Oct 1, 2017 Accepting new patients
St. Luke'S Warren Physician Group, PC CurrentSince Aug 1, 2024 Accepting new patients
Gslpg, Inc CurrentSince Apr 1, 2024 Accepting new patients
St. Luke'S Warren Physician Group, PC Current Accepting new patients
St. Luke'S Physician Group, Inc. CurrentSince Oct 1, 2017 Accepting new patients
St. Luke'S Warren Physician Group, PC CurrentSince Aug 1, 2024 Accepting new patients
St. Luke'S Physician Group, Inc. Family Medicine Current Accepting new patients
St. Luke'S Physician Group, Inc. Past Accepting new patients
Gslpg Inc Family Medicine Past Accepting new patients
St. Luke'S Physician Group, Inc Past Accepting new patients

Locations

185 Roseberry St
Bldg 2ND
Phillipsburg, NJ 08865
Phone (908) 847-2619

185 Roseberry St
Phillipsburg, NJ 08865
Phone (908) 213-6611

279 State Route 31 S
Washington, NJ 07882
Phone (908) 689-2201

315 State Route 31 S
Washington, NJ 07882
Phone (908) 689-0777

421 Chew St
Allentown, PA 18102
Phone (610) 776-4500

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

100 Paramount Blvd
Orwigsburg, PA 17961
Phone (272) 639-1000

Interoperability endpoints

  • Direct secure messaging: diedra.mccafferty@slpg.direct-sluhn.org

Organizations & group practices 10

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1251763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460592000000",
    "number": "1720211196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "432 N 6TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191234004",
            "telephone_number": "215-925-2400",
            "fax_number": "215-925-9162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191474717",
            "telephone_number": "215-339-5100",
            "fax_number": "215-454-6814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCAFFERTY",
        "first_name": "DIEDRA",
        "middle_name": "ELENA AMENDOLA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-01",
        "last_updated": "2016-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "UO 2270",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS016486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.