Amidou Diarrassouba, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

6271 Fleetwood CT Apt 2
Fort Riley, KS 66442-3333

Phone

(646) 730-2841

NPI assigned

Oct 7, 2019

Last updated

Aug 26, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1570406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1912548256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 WALTON AVE APT 4BS",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104527807",
            "telephone_number": "646-730-2841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6271 FLEETWOOD CT APT 2",
            "city": "FORT RILEY",
            "state": "KS",
            "postal_code": "664423333",
            "telephone_number": "646-730-2841"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1265 Walton Ave Apt 4Bs",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104527807",
            "country_code": "US",
            "telephone_number": "646-730-2841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIARRASSOUBA",
        "first_name": "AMIDOU",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-10-07",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ccny.cuny.edu",
            "affiliation": "N",
            "address_1": "572 Leland Ave Apt 3",
            "city": "Bronx",
            "state": "NY",
            "country_code": "US",
            "postal_code": "104732910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Charles David Day, PA-C, MPAS
• Maria Gabriela Dean
• Karla Michelle Demuth, APRN
• Melissa Dennison, LSCSW
• Karlyn Suzanne Devlin, LSCSW, LCSW
• Alexander John Dickerson
• Katlyn Dillon
• Directorate Morale Welfare Recreation
• Marlena Renee Dobbs, DDS
• Michael Thomas Dolan Jr., DO

• Physician Assistant in Fort Riley, KS
• Providers in Fort Riley, KS by specialty
• Physician Assistant in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.