Individual provider Active NPI

Alyssa Lafave, PA-C

  • Medical Physician Assistant
  • Erwin, NC
National Provider Identifier
1811767726
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0010-14538 Issued in NC
Practice address
25 Professional Park
Erwin, NC 28339-9105
Phone
(910) 292-4097
NPI assigned
Jan 3, 2024
Last updated
Jan 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X
Medical Physician Assistant 363AM0700X 0010-14538 NC Primary

Addresses

Primary practice location

25 Professional Park
Erwin, NC 28339-9105

Mailing address

2536 Whakatane LN
Fuquay Varina, NC 27526-3839
Phone (570) 994-8483

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20241127004295 NC Practitioner - Physician Assistant 1951836964 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1120 SE Cary Pkwy
Suite 100
Cary, NC 27518-7413
Phone (919) 467-4992

130 James Ave
Locust, NC 28097-4506
Phone (704) 296-4508

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0010-14538NCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mainstreet and Kidsstreet of North Carolina PLLC CurrentSince Sep 16, 2024 Accepting new patients
Mainstreet and Kidsstreet of North Carolina PLLC CurrentSince Sep 16, 2024 Accepting new patients

Locations

1500 1st Ave N
Unit 3
Birmingham, AL 35203
Phone (205) 545-5088

25 Professional Park
Erwin, NC 28339
Phone (910) 292-4097

130 James Ave
Locust, NC 28097
Phone (704) 271-3777

Organizations & group practices 3

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": "1704240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1811767726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2536 WHAKATANE LN",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275263839",
            "telephone_number": "570-994-8483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 PROFESSIONAL PARK",
            "city": "ERWIN",
            "state": "NC",
            "postal_code": "283399105",
            "telephone_number": "910-292-4097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAFAVE",
        "first_name": "ALYSSA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-03",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-14538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erwin, NC

Sources for this page

Verify at the official NPI Registry.