ALICIA RENEE EDELBLUTE PA-C
NPI 1003143330
Physician Assistant - Medical in Newark, DE

NPI Status: Active since November 06, 2009

Contact Information

4755 OGLETOWN STANTON RD
NEWARK, DE
ZIP 19718
Phone: (610) 406-7662

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  • Individual
  • Female
  • Years of Experience 17
  • Physician Assistant
  • Medical
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About ALICIA EDELBLUTE

This page provides the complete NPI Profile along with additional information for Alicia Edelblute, a primary care provider established in Newark, Delaware with a medical specialization in Physician Assistant, focusing in medical and more than 17 years of experience. The healthcare provider is registered in the NPI registry with number 1003143330 assigned on November 2009. The practitioner's primary taxonomy code is 363AM0700X with license number DE C5 0000687 (DE). The provider is registered as an individual and her NPI record was last updated 13 years ago.

NPI
1003143330
Provider Name
ALICIA RENEE EDELBLUTE PA-C
Gender
Female
Entity Type
Individual
Location Address
4755 OGLETOWN STANTON RD NEWARK, DE 19718
Location Phone
(610) 406-7662
Mailing Address
4299 RIDERS LN UPPER CHICHESTER, PA 19061
Mailing Phone
(610) 406-7662
Medical School Name
OTHER
Graduation Year
2009
Is Sole Proprietor?
No
Enumeration Date
11-06-2009
Last Update Date
04-17-2013
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A primary care provider (PCP) like Alicia Edelblute sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physician Assistant Medical

Taxonomy Code
363AM0700X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
DE C5 0000687
License State
DE

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Choice Bronze HSA - EPO
  • Choice Bronze HSA + Vision + Adult Dental - EPO
  • Clear Silver - EPO
  • Clear Silver + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Choice Bronze HSA - EPO
  • Choice Bronze HSA + Vision + Adult Dental - EPO
  • Clear Gold - EPO
  • Clear Gold + Vision + Adult Dental - EPO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Bronze - EPO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Clear Gold - EPO
  • Clear Gold + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Silver - EPO
  • Elite Silver + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • AmeriHealth Caritas Next Bronze Essential + No Referrals - HMO
  • AmeriHealth Caritas Next Bronze Premier + No Referrals - HMO
  • AmeriHealth Caritas Next Bronze Signature + No Referrals - HMO
  • AmeriHealth Caritas Next Gold Premier + No Referrals - HMO
  • AmeriHealth Caritas Next Gold Signature + No Referrals - HMO
  • AmeriHealth Caritas Next Silver Essential + No Referrals - HMO
  • AmeriHealth Caritas Next Silver Premier + No Referrals - HMO
  • AmeriHealth Caritas Next Silver Signature + No Referrals - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
DE C50000687OTHER (01)DEDE STATE BOARD OF MEDICINE

Medicare Participation & PECOS Enrollment Status

Alicia Edelblute is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Alicia Edelblute is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 244455699

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20170720000114, I20210506001032

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1003143330, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 50. The final step is to find the difference between that total and the next multiple of ten (50 - 50 = 0).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
0
Doubled → 0
Pos 4
3
Unchanged
Pos 5
1
Doubled → 2
Pos 6
4
Unchanged
Pos 7
3
Doubled → 6
Pos 8
3
Unchanged
Pos 9
3
Doubled → 6
Check
0
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 1 → 2 3 → 6 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 0 + 3 + 2 + 4 + 6 + 3 + 6 + 24 = 50

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 50 is 50. The difference is the calculated check digit.

50 - 50 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1003143330.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Pathology (Anatomic Pathology & Clinical Pathology)
4755 OGLETOWN STANTON RD
NEWARK, DE 19718
Pathology (Anatomic Pathology & Clinical Pathology)
4755 OGLETOWN STANTON RD
NEWARK, DE 19718
Pathology (Anatomic Pathology & Clinical Pathology)
4755 OGLETOWN STANTON RD
NEWARK, DE 19718
Pathology (Anatomic Pathology & Clinical Pathology)
4755 OGLETOWN STANTON RD
NEWARK, DE 19718
Pathology (Anatomic Pathology & Clinical Pathology)
4755 OGLETOWN STANTON RD
NEWARK, DE 19718
Pathology (Anatomic Pathology & Clinical Pathology)
4755 OGLETOWN STANTON RD
NEWARK, DE 19718
Obstetrics & Gynecology
4755 OGLETOWN STANTON RD, DEPT. OF OB/GYN
NEWARK, DE 19718
Internal Medicine
4755 OGLETOWN STANTON RD, NEWARK
NEWARK, DE 19718
Emergency Medicine
4755 OGLETOWN STANTON RD
NEWARK, DE 19718
Emergency Medicine
4755 OGLETOWN STANTON RD
NEWARK, DE 19718
Emergency Medicine
4755 OGLETOWN STANTON RD
NEWARK, DE 19718
Emergency Medicine
4755 OGLETOWN STANTON RD
NEWARK, DE 19718
Emergency Medicine
4755 OGLETOWN STANTON RD
NEWARK, DE 19718
Emergency Medicine
4755 OGLETOWN STANTON RD
NEWARK, DE 19718
Pediatrics
4755 OGLETOWN STANTON RD, CHRISTIANA HOSPITAL, DEPT OF PEDIATRICS
NEWARK, DE 19718
Pediatrics (Neonatal-Perinatal Medicine)
4755 OGLETOWN STANTON RD, DEPT. OF PEDIATRICS
NEWARK, DE 19718
Emergency Medicine
4755 OGLETOWN STANTON RD
NEWARK, DE 19718
Emergency Medicine
4755 OGLETOWN STANTON RD
NEWARK, DE 19718
Emergency Medicine
4755 OGLETOWN STANTON RD
NEWARK, DE 19718
Physician Assistant
4755 OGLETOWN STANTON RD
NEWARK, DE 19718

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1003143330, enumerated as an "individual" on November 06, 2009.

The provider is located at 4755 OGLETOWN STANTON RD NEWARK, DE 19718 and the phone number is (610) 406-7662.

Physician Assistant with taxonomy code 363AM0700X and a focus in Medical.

The provider might be accepting Accepts: Ambetter from Home State Health, Ambetter from NH. Please consult your insurance carrier or call the provider to verify.