Individual provider Active NPI

Laura E Wildman, PAC

  • Surgical Physician Assistant
  • West Chester, PA
National Provider Identifier
1942391016
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
MA050709 Issued in PA
Practice address
701 E Marshall St
West Chester, PA 19380-4412
Phone
(610) 738-8016
Fax
(610) 918-6316
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X MA050709 PA Primary

Addresses

Primary practice location

701 E Marshall St
West Chester, PA 19380-4412

Mailing address

701 E Marshall St
West Chester, PA 19380-4412
Phone (610) 738-8016

Other names 1

  • Laura E Burchett Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20070724000447 PA Practitioner - Physician Assistant 1759482573 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

701 E Marshall St
West Chester, PA 19380-4412

777 Township Line Rd
Suite 200
Yardley, PA 19067-5564
Phone (215) 860-0775

Hospital & facility affiliations

  • Chester County Hospital Hospital, West Chester, PA, CCN 390179

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA050709PAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Care Associates of the University of CurrentSince Mar 17, 2020 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Mar 17, 2020 Accepting new patients
Chester County Hospital CurrentSince May 3, 2013 Accepting new patients

Locations

915 Old Fern Hill Rd
Bldg D
West Chester, PA 19380
Phone (610) 235-4100

701 E Marshall St
West Chester, PA 19380
Phone (610) 431-5000

915 Old Fern Hill Rd
Ste 201
West Chester, PA 19380
Phone (610) 436-6696

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Organizations & group practices 5

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942391016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 E MARSHALL ST",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193804412",
            "telephone_number": "610-738-8016",
            "fax_number": "610-918-6316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E MARSHALL ST",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193804412",
            "telephone_number": "610-738-8016",
            "fax_number": "610-918-6316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDMAN",
        "first_name": "LAURA",
        "middle_name": "E",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA050709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "BURCHETT",
            "middle_name": "E",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in West Chester, PA

Sources for this page

Verify at the official NPI Registry.