Basic Information
| Provider Information | |||||||||
| NPI: | 1225217656 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ACCARDI | ||||||||
| FirstName: | MELINDA | ||||||||
| MiddleName: | N | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | PA-C | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | DICKEN | ||||||||
| OtherFirstName: | MELINDA | ||||||||
| OtherMiddleName: | N | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 785 5TH AVE STE 3 | ||||||||
| Address2: | |||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172014232 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172639555 | ||||||||
| FaxNumber: | 7172174217 | ||||||||
| Practice Location | |||||||||
| Address1: | 12 ST. PAUL DRIVE | ||||||||
| Address2: | SUITE 207 | ||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 17201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172176882 | ||||||||
| FaxNumber: | 7172176883 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/02/2007 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | MA054392 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
ID Information
| ID | Type | State | Issuer | Description | 25-1716306 | 01 | PA | DEVON HEALTHCARE | OTHER | 50095025 | 01 | PA | CAPITAL BLUE CROSS | OTHER | 25-1716306 | 01 | PA | PHCS/MULTIPLAN | OTHER | 103148650 | 05 | PA | MEDICAID | 25-1716306 | 01 | PA | INTERGROUP | OTHER | 25-1716306 | 01 | PA | GREATWEST | OTHER | P00841809 | 01 | PA | RAILROAD MEDICARE | OTHER | 50095023 | 01 | PA | CAPITAL BLUE CROSS (POTOMAC OB/GYN) | OTHER | 867633 | 01 | PA | MEDICARE GROUP # | OTHER | MD2004024 | 01 | PA | DEA | OTHER | 25-1716306 | 01 | PA | HEALTH AMERICA/COVENTRY | OTHER | 9882549 | 01 | PA | AETNA NON-HMO | OTHER | 19389 | 01 | CA | PHYSICIAN ASSISTANT COM. | OTHER | 1382847 | 01 | PA | AETNA HMO | OTHER | 25-1716306 | 01 | PA | GATEWAY HEALTH PLAN | OTHER | 25-1716306 | 01 | PA | HEALTH NET/TRICARE | OTHER | 25-1716306 | 01 | PA | INFORMED | OTHER |