Individual provider Active NPI

Cayla Cirsten Daniele, PA-C

  • Medical Physician Assistant
  • Derby, CT
National Provider Identifier
1770025132
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
3684 Issued in CT
Practice address
300 Seymour Ave Suite 102
Derby, CT 06418-1343
Phone
(203) 516-5303
Fax
(203) 732-8136
NPI assigned
Nov 16, 2016
Last updated
Oct 22, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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 3684 CT
Medical Physician Assistant 363AM0700X 3684 CT Primary

Addresses

Primary practice location

300 Seymour Ave Suite 102
Derby, CT 06418-1343

Mailing address

67 Maple Ave
Derby, CT 06418-1328
Phone (203) 732-1256

Other practice location 1

4 Corporate Dr Ste 484
Shelton, CT 06484-6241
Phone (203) 944-9898

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20170323000098 CT Practitioner - Physician Assistant 2264717891 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Griffin Faculty Physicians IncGroup PAC ID 7618871997, 125 clinicians

Practice addresses (Care Compare)

130 Division St
Derby, CT 06418-1326
Phone (203) 732-1352

300 Seymour Ave
Derby, CT 06418-1343

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as group
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3684CTMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Women's Health Center, PC PastSince May 18, 2015 Accepting new patients
Scott a Vander Vennet MD LLC PastSince Jan 10, 2005 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: cayla.daniele.1@1323.direct.athenahealth.com

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.

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": "1479254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1770025132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 MAPLE AVE",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064181328",
            "telephone_number": "203-732-1256",
            "fax_number": "203-732-1539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SEYMOUR AVE SUITE 102",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064181343",
            "telephone_number": "203-516-5303",
            "fax_number": "203-732-8136"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4 Corporate Dr Ste 484",
            "address_purpose": "LOCATION",
            "city": "Shelton",
            "state": "CT",
            "postal_code": "064846241",
            "country_code": "US",
            "telephone_number": "203-944-9898",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DANIELE",
        "first_name": "CAYLA",
        "middle_name": "CIRSTEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-16",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "3684",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "3684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Derby, CT

Sources for this page

Verify at the official NPI Registry.