Individual provider Active NPI

Anthony Joseph Daurora Jr., PA-C

  • Physician Assistant
  • Erie, PA
National Provider Identifier
1932710944
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA061797 Issued in PA
Practice address
2315 Myrtle St Ste L10
Erie, PA 16502-4611
Phone
(814) 454-2401
Fax
(814) 459-5992
NPI assigned
Aug 12, 2020
Last updated
Dec 9, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA061797 PA Primary

Addresses

Primary practice location

2315 Myrtle St Ste L10
Erie, PA 16502-4611

Mailing address

2315 Myrtle St Ste L10
Erie, PA 16502-4611
Phone (814) 454-2401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20220222000122 CO Practitioner - Physician Assistant 3870907785 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

3676 Parker Blvd
Pueblo, CO 81008-2213

3676 Parker Blvd
Suite 390
Pueblo, CO 81008-2215
Phone (719) 595-7780

400 W 16TH St
Pueblo, CO 81003-2745
Phone (719) 584-4921

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Jun 1, 2025 Accepting new patients

Locations

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

3676 Parker Blvd
Ste 350
Pueblo, CO 81008
Phone (719) 296-6000

Organizations & group practices 2

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.

Hospital & facility affiliations 8

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": "1597190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1932710944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 MYRTLE ST STE L10",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165024611",
            "telephone_number": "814-454-2401",
            "fax_number": "814-459-5992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 MYRTLE ST STE L10",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165024611",
            "telephone_number": "814-454-2401",
            "fax_number": "814-459-5992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAURORA",
        "first_name": "ANTHONY",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-12",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA061797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.