Active NPI
Daniel Paul Stroup, PA-C
- Medical Physician Assistant
- Erie, PA
National Provider Identifier
1902864028
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- MA052218
- Practice address
- 2315 Myrtle Street
Suite 190
Erie, PA 16502-4604 - Phone
- (814) 453-7767
- Fax
- (814) 454-6667
- NPI assigned
- May 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | MA052218 | PA | Primary |
| Medical Physician Assistant | 363AM0700X | OA002463 | PA |
Addresses
Primary practice location
2315 Myrtle Street
Suite 190
Erie, PA 16502-4604
Mailing address
2315 Myrtle Street
Suite 190
Erie, PA 16502-4604
Phone (814) 453-7767
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OA002463 | PA | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328745600000",
"number": "1902864028",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2315 MYRTLE STREET",
"address_2": "SUITE 190",
"city": "ERIE",
"state": "PA",
"postal_code": "165024604",
"telephone_number": "814-453-7767",
"fax_number": "814-454-6667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2315 MYRTLE STREET",
"address_2": "SUITE 190",
"city": "ERIE",
"state": "PA",
"postal_code": "165024604",
"telephone_number": "814-453-7767",
"fax_number": "814-454-6667"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STROUP",
"first_name": "DANIEL",
"middle_name": "PAUL",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-01",
"last_updated": "2012-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "PA",
"license": "MA052218",
"primary": true
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "PA",
"license": "OA002463",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Erie, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.