| Mr Jody James Decastro, PA-C | |
|
1910 Sassafras St Ste 300, Erie, PA 16502-2716 | |
| (814) 452-7575 | |
| (814) 452-7574 |
| Full Name | Mr Jody James Decastro |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 16 Years |
| Location | 1910 Sassafras St Ste 300, Erie, Pennsylvania |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457633943 | NPI | - | NPPES |
| 12292814 | Other | CAQH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | 015034 (New York) | Secondary |
| 363AM0700X | Physician Assistant - Medical | MA055017 (Pennsylvania) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Upmc Chautauqua At Wca | Jamestown, NY | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Umamaheswara Rao Vejendla Physician Pc | 9133180888 | 4 |
| Entity Name | Umamaheswara Rao Vejendla Physician PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1407074057 PECOS PAC ID: 9133180888 Enrollment ID: O20041026000082 |
| Entity Name | Great Lakes Physician Practice PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1730599176 PECOS PAC ID: 6709007701 Enrollment ID: O20141016000108 |
| Entity Name | Chautauqua County Chapter of Nysarc Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770972036 PECOS PAC ID: 9234452947 Enrollment ID: O20150106000023 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Jody James Decastro, PA-C 152 Foote Avenue, Jamestown, NY 14701 Ph: (716) 664-5290 | Mr Jody James Decastro, PA-C 1910 Sassafras St Ste 300, Erie, PA 16502-2716 Ph: (814) 452-7575 |
Dynara Mirone, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4247 W Ridge Rd, Erie, PA 16506 Phone: 814-835-2580 |
Colleen Kassandra Dominici, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 201 State St, Erie, PA 16550 Phone: 814-877-4922 Fax: 814-877-3622 |
Larae Tymochko, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 2315 Myrtle St Ste 160, Erie, PA 16502 Phone: 814-456-9197 Fax: 814-455-2765 |
Katharine Theresa Ressler, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2500 W 12th St, Erie, PA 16505 Phone: 814-836-2600 |
Elizabeth Arduini, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 120 E 2nd St Fl 2, 2nd Floor, Erie, PA 16507 Phone: 814-456-8980 |
Sarah Al-asady, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 2315 Myrtle St Ste L10, Erie, PA 16502 Phone: 814-453-7767 Fax: 814-454-6667 |
Mr. Martin Pan Hong, PA - C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 232 W 25th St, Erie, PA 16544 Phone: 814-452-5354 |