Ethan Fadale, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA061845 Issued in PA

Practice address

1809 W Oregon Ave Ste 100
Philadelphia, PA 19145-3700

Phone

(215) 389-3890

Fax

(215) 551-0368

NPI assigned

Dec 17, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Jefferson Medical College of Thomas Jefferson University, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cardiology Consultants of Philadelphia PCGroup PAC ID 5294620746, 154 clinicians

Methodist Associates in Healthcare, IncGroup PAC ID 6406755651, 387 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ethan.fadale@advancedcardiologyofsouthjersey.chartmakerdirect.com

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.

• Cardiology Consultants of Philadelphia, P.C.

  • Cardiovascular Disease Physician
  • Philadelphia, PA
  • NPI 1649272386
  Medicare reassignment Care Compare group
• Methodist Associates in Healthcare, Inc

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1053355131
  Medicare reassignment Care Compare group
• Methodist Associates in Healthcare, Inc

  • Neurological Surgery Physician
  • Philadelphia, PA
  • NPI 1790390813
  NPD
• Methodist Associates in Healthcare, Inc.

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1033575352
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Thomas Jefferson University Hospitals Inc

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1215916002
  Care Compare affiliation

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

{
    "created_epoch": "1608163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1982290656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 N COLLEGE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191214808",
            "telephone_number": "570-898-9884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 W OREGON AVE STE 100",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191453700",
            "telephone_number": "215-389-3890",
            "fax_number": "215-551-0368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADALE",
        "first_name": "ETHAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-17",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA061845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carly Alexis Fabrizio, D.O.
• Joseph Robert Fabrizio
• Jacie Fabro
• Hannah Nelkin Facey, MD
• Daniel Justin Fadale, M.D.
• Fademos Family Practice
• Francesca Fadgen
• Nada Fadl, DO
• Olajumoke Olanrewaju Fadugba, MD
• Issam M Fadul, MS

• Physician Assistant in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.