Individual provider Active NPI

Kaveena Julisa Little, PA-C

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1831809789
Registry record updated Mar 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA064250 Issued in PA
Practice address
4417 N 6TH St
Philadelphia, PA 19140-2319
Phone
(215) 302-3600
NPI assigned
Dec 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X RTO000394 PA
Physician Assistant 363A00000X C5-0012037 DE
Physician Assistant 363A00000X MA064250 PA Primary

Addresses

Primary practice location

4417 N 6TH St
Philadelphia, PA 19140-2319

Mailing address

4417 N 6TH St
Philadelphia, PA 19140-2319
Phone (215) 302-3600

Other practice location 1

4735 Ogletown Stanton Rd Ste 3301
Newark, DE 19713-7021
Phone (302) 623-4370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20240308000470 DE Practitioner - Physician Assistant 8123499092 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christiana Care Health Services IncGroup PAC ID 9739097569, 1,480 clinicians

Practice addresses (Care Compare)

4755 Ogletown Stanton Rd
Newark, DE 19718-2200

501 W 14TH St
Wilmington, DE 19801-1013

501 W 14TH St FL
6 CCHS Infectious Disease
Wilmington, DE 19801-1013
Phone (302) 320-1300

501 W 14TH St Wilmington Hospital
Wilmington, DE 19801-1013

Hospital & facility affiliations

  • Christiana Hospital Hospital, Newark, DE, CCN 080001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RTO000394PAMDAthletic Trainer
C5-0012037DEMDPhysician Assistant
MA064250PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services Inc CurrentSince Feb 23, 2024 Accepting new patients
Christiana Care Health Services, Inc Physician Assistant CurrentSince Feb 23, 2024 Accepting new patients
Christiana Care Health Services, Inc Past Accepting new patients

Locations

4701 Ogletown Stanton Rd
Ste 1500
Newark, DE 19713
Phone (302) 623-4343

4735 Ogletown Stanton Rd
Ste 3301
Newark, DE 19713
Phone (302) 623-4370

501 W 14th St
#4154
Wilmington, DE 19801
Phone (302) 428-4175

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

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 and National Provider Directory roles.

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": "1669852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1831809789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4417 N 6TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191402319",
            "telephone_number": "215-302-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4417 N 6TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191402319",
            "telephone_number": "215-302-3600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4735 Ogletown Stanton Rd Ste 3301",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "DE",
            "postal_code": "197137021",
            "country_code": "US",
            "telephone_number": "302-623-4370",
            "fax_number": "302-623-4375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LITTLE",
        "first_name": "KAVEENA",
        "middle_name": "JULISA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-01",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RTO000394",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0012037",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA064250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.