CMS-1500 Box 24J / 33a • NPI
1194791921
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363A00000X (CMS 97)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant
Box 32 Service Location & ZIP+4
217 KING STREET, LAPORTE, PA, 18626-0095
✓ 9-Digit EDI 837 ZIP+4 (18626-0095)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1194791921 (AMBER JULIA PEDRO, PA-C) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Medicare Part B
✓ Eligible
DMEPOS Ordering
✓ Eligible
Home Health (HHA)
✓ Eligible
Power Mobility
✓ Eligible
Hospice Referring
No
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1194791921 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | AMBER JULIA PEDRO, PA-C |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant NUCC Code: 363A00000X (Physician Assistant) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 217 KING STREET, LAPORTE, PA, 18626-0095 |
| Practice Telephone / Fax | Tel: (570) 946-5101 | Fax: (570) 946-4341 |
| Administrative Mailing Address | 7 DOCK HILL RD, MIDDLEBURG, PA, 17842-8910 |
| Enumeration & Last Sync | Enumerated: 2006-02-23 | CMS Record Updated: 2024-04-30 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363A00000X)
What Does Taxonomy Code 363A00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363A00000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (AMBER JULIA PEDRO, PA-C)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
363A00000X — Physician AssistantPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant | State: PA | License: MA052953 | Primary: Secondary |
363A00000X — Physician AssistantPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant | State: PA | License: OA000766 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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