Individual provider Active NPI

Alaina Terez King, PA-C

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1790341030
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
111 S 11TH St
Philadelphia, PA 19107-4824
Phone
(215) 955-6840
NPI assigned
May 13, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

111 S 11TH St
Philadelphia, PA 19107-4824

Mailing address

789 E Lancaster Ave
Suite 110
Villanova, PA 19085
Phone (239) 898-0829

Other practice location 1

17007 Wrigley Cir
Fort Myers, FL 33908-3802
Phone (239) 898-0829

Other names 1

  • Alaina Terez Todd Former name

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
I20200318001711 PA Practitioner - Physician Assistant 3173951571 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Acute Care Physicians, PC CurrentSince Feb 14, 2020 Accepting new patients
Jefferson Acute Care Physicians, PC CurrentSince Feb 14, 2020 Accepting new patients
Jefferson University Physicians CurrentSince Feb 14, 2020 Accepting new patients
Jefferson University Physicians Past Accepting new patients
Methodist Associates in Healthcare, Inc PastSince Oct 20, 2024 Accepting new patients

Locations

1020 Sansom St
Ste 239
Philadelphia, PA 19107
Phone (215) 955-6844

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

111 S 11th St
Philadelphia, PA 19107
Phone (215) 955-6161

Organizations & group practices 6

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": "1557705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1790341030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "789 E LANCASTER AVE",
            "address_2": "SUITE 110",
            "city": "VILLANOVA",
            "state": "PA",
            "postal_code": "19085",
            "telephone_number": "239-898-0829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-6840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17007 Wrigley Cir",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339083802",
            "country_code": "US",
            "telephone_number": "239-898-0829",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "ALAINA",
        "middle_name": "TEREZ",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-13",
        "last_updated": "2024-10-18",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALAINA",
            "last_name": "TODD",
            "middle_name": "TEREZ",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.