Individual provider Active NPI

Alyssa Dawn Neil, PA-C

  • Physician Assistant
  • Pasco, WA
National Provider Identifier
1760017164
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61011431 Issued in WA
Practice address
7425 Wrigley Dr Ste 100
Pasco, WA 99301-5292
Phone
(509) 416-8888
NPI assigned
Mar 5, 2020
Last updated
Aug 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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 PA61011431 WA Primary

Addresses

Primary practice location

7425 Wrigley Dr Ste 100
Pasco, WA 99301-5292

Mailing address

520 N 4TH Ave
Pasco, WA 99301-5257
Phone (509) 416-8849

Other identifiers 2

IdentifierTypeStateIssuer
2158016MedicaidWA
425748OtherWALNI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20200623000967 WA Practitioner - Physician Assistant 2264854140 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA61011431WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lourdes Hospital LLC CurrentSince Jun 1, 2020 Accepting new patients
Lourdes Hospital LLC CurrentSince Jun 1, 2020 Accepting new patients
American Current Care of Washington, P.S. CurrentSince Dec 6, 2024 Accepting new patients

Locations

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

1925 140th Ave NE
Bellevue, WA 98005
Phone (425) 865-8060

3101 111th St SW
Unit Tu
Everett, WA 98204
Phone (425) 267-0299

1200 N 14th Ave
Pasco, WA 99301
Phone (509) 547-7536

520 N 4th Ave
Pasco, WA 99301
Phone (509) 544-6140

7425 Wrigley Dr
Ste 100
Pasco, WA 99301
Phone (509) 416-8888

7425 Wrigley Dr
Ste 204
Pasco, WA 99301
Phone (509) 416-0027

9222 N Newport Hwy
Ste 1
Spokane, WA 99218
Phone (509) 467-4545

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1583366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1760017164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 N 4TH AVE",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993015257",
            "telephone_number": "509-416-8849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7425 WRIGLEY DR STE 100",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993015292",
            "telephone_number": "509-416-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEIL",
        "first_name": "ALYSSA",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-05",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61011431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2158016",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LNI",
            "identifier": "425748",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasco, WA

Sources for this page

Verify at the official NPI Registry.