DANIELLE MARIE PRUDENTE PA-C
NPI 1801750757
Physician Assistant - Medical in Wilkes Barre, PA

Q: What is Danielle Prudente's NPI number?

The NPI number for Danielle Prudente is 1801750757. It was assigned to this individual provider in the NPPES registry on December 15, 2025.

Q: What is Danielle Prudente's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Danielle Prudente was last updated on March 13, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since December 15, 2025PECOS EnrolledAccepts Medicare Assignment

1155 E MOUNTAIN BLVD, WILKES BARRE, PA 18702(570) 808-7300(570) 808-6006 Get Directions Write a Review

NPPES record last updated: March 13, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 13, 2026, Dec 19, 2025 (2 updates tracked since 2025).

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About Danielle Marie Prudente Pa-c NPPES

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

DANIELLE MARIE PRUDENTE PA-C (NPI 1801750757) is an individual medical provider in Wilkes Barre, Pennsylvania, licensed in Pennsylvania (MA067375) and active in the NPI registry since December 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1801750757

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameDANIELLE MARIE PRUDENTECredential: PA-C

Location Address1155 E MOUNTAIN BLVDWilkes Barre, PA 18702-7906

Mailing Address100 N Academy AveDanville, PA 17822-4903 · (570) 808-7916 · Fax (570) 808-6006

Phone(570) 808-7300

Fax(570) 808-6006

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateDecember 15, 2025

Last NPPES UpdateMarch 13, 20262 updates tracked since enumeration

NPPES CertifiedMarch 13, 2026

✔ NPI 1801750757 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in PA · MA067375

Also ListedPhysician AssistantTaxonomy 363A00000X · License OA007546 (PA)

1155 E MOUNTAIN BLVD, Wilkes Barre, PA 18702

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Danielle Marie Prudente Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6709369887

PECOS Enrollment IDI20260317002201

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.

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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.

MRS. CAROLYN TERESA CLARK RN BSN

Registered Nurse