Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Diara Alessandra Vicedomini, PA

Individual provider Physician Assistant · NPI 1821727744

Diara Alessandra Vicedomini, PA is a Physician Assistant in Bronx, New York. Qualified in 2022, 4 years ago. Practices with Urban Health Plan Inc, a 157-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
4
Licensed in
NY
In the registry since
2022
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1065 Southern Blvd
Bronx, NY 10459-2417
Phone: (718) 589-2440
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 028873 (NY)

Record details

NPI number1821727744
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 7, 2022
Last updated in NPPESOctober 7, 2022
Certification dateSeptember 16, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Urban Health Plan Inc — 157 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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