Individual provider Active NPI

Anna Maria Domingo Seaford

  • Physician Assistant
  • Wynnewood, PA
National Provider Identifier
1740704253
Registry record updated May 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110005790 Issued in VA
Practice address
100 E Lancaster Ave Ste 230
Wynnewood, PA 19096-3451
Phone
(484) 476-4944
NPI assigned
Jul 27, 2017
Last updated
May 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110005790 VA Primary

Addresses

Primary practice location

100 E Lancaster Ave Ste 230
Wynnewood, PA 19096-3451

Mailing address

100 E Lancaster Ave Ste 230
Wynnewood, PA 19096-3451

Other practice location 1

2579 John Milton Dr Ste 300
Herndon, VA 20171
Phone (703) 828-0799

Other practice location 2

19441 Golf Vista Plz Ste 230
Lansdowne, VA 20176
Phone (703) 729-3420

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
I20251009004197 PA Practitioner - Physician Assistant 9032485255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pulmonology Associates IncGroup PAC ID 5698757763, 18 clinicians

Practice addresses (Care Compare)

100 E Lancaster Ave
Wynewood, PA 19096-3450
Phone (610) 642-3796

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110005790VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pulmonology Associates Inc CurrentSince Sep 1, 2025 Accepting new patients
Main Line Healthcare PastSince May 8, 2022 Accepting new patients

Locations

255 W Lancaster Ave
Ste 124
Paoli, PA 19301
Phone (610) 648-0553

100 E Lancaster Ave
Ste 230
Wynnewood, PA 19096
Phone (610) 642-3796

100 E Lancaster Ave
Ste W230
Wynnewood, PA 19096
Phone (610) 642-3796

100 E Lancaster Ave
Ste 230W
Wynnewood, PA 19096

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DJJDBA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1501113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1740704253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE STE 230",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE STE 230",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963451",
            "telephone_number": "484-476-4944"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2579 John Milton Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Herndon",
            "state": "VA",
            "postal_code": "20171",
            "country_code": "US",
            "telephone_number": "703-828-0799",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19441 Golf Vista Plz Ste 230",
            "address_purpose": "LOCATION",
            "city": "Lansdowne",
            "state": "VA",
            "postal_code": "20176",
            "country_code": "US",
            "telephone_number": "703-729-3420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEAFORD",
        "first_name": "ANNA MARIA",
        "middle_name": "DOMINGO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-27",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110005790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynnewood, PA

Sources for this page

Verify at the official NPI Registry.