Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DEIONTE TAUN HARRILLA-GRAY PA-C
NPI 1679348205
Physician Assistant in Philadelphia, PA

Q: What is Deionte Harrilla-gray's NPI number?

The NPI number for Deionte Harrilla-gray is 1679348205. It was assigned to this individual provider in the NPPES registry on November 27, 2023.

Q: What is Deionte Harrilla-gray's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Active since November 27, 2023PECOS Enrolled

1412 FAIRMOUNT AVE, PHILADELPHIA, PA 19130(215) 684-5344 Get Directions Write a Review

NPPES record last updated: September 22, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Sep 22, 2026, Jul 3, 2024, Jun 26, 2024 and 2 more (5 updates tracked since 2024).

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About Deionte Taun Harrilla-gray Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DEIONTE TAUN HARRILLA-GRAY PA-C (NPI 1679348205) is an individual physician assistant in Philadelphia, Pennsylvania, licensed in Pennsylvania (OA006887) and active in the NPI registry since November 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1679348205

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameDEIONTE TAUN HARRILLA-GRAYCredential: PA-C

Location Address1412 FAIRMOUNT AVEPhiladelphia, PA 19130-2908

Mailing Address1412 Fairmount AvePhiladelphia, PA 19130-2908

Phone(215) 684-5344

Sole ProprietorNo

Enumeration DateNovember 27, 2023

Last NPPES UpdateSeptember 22, 20265 updates tracked since enumeration

NPPES CertifiedSeptember 22, 2026

✔ NPI 1679348205 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Licenses✔ Licensed in PA · OA006887✔ Licensed in NY · 031202✔ Licensed in PA · MA065666

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

1412 FAIRMOUNT AVE, Philadelphia, PA 19130

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Other Identifiers 8

Medicaid1043588860003PA

Medicaid1043588860002PA

Medicaid1043588860007PA

Medicaid1043588860006PA

Medicaid1043588860008PA

Medicaid1043588860004PA

Medicaid1043588860001PA

Medicaid1043588860005PA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Deionte Taun Harrilla-gray Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19130 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$92.69 typical visit price

range $59.88 – $180.99

Typical copayment $23.17 (range $14.97 – $45.24)

Most-billed visit code 99203

Established Patient

$74.47 typical visit price

range $19.30 – $147.29

Typical copayment $18.61 (range $4.82 – $36.82)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KAREN EMILY ORZECHOWSKI MD

Student in an Organized Health Care Education/Training Program