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

Elissa Pettinato, PA-C

Individual provider Physician Assistant · NPI 1962936336

Elissa Pettinato, PA-C is a Physician Assistant in Philadelphia, Pennsylvania. Qualified in 2016, 10 years ago. Practices with Eastern Pennsylvania Physician Alliance, LLC, a 110-clinician group and accepts Medicare assignment. Licensed in New Jersey and Pennsylvania.

Years since qualifying
10
Licensed in
NJ, PA
In the registry since
2017
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

561 Fairthorne Ave
Philadelphia, PA 19128-2412
Phone: (800) 235-0200
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence MA058812 (PA)
Physician Assistant Taxonomy 363A00000X · Licence OA004035 (PA)
Physician Assistant Taxonomy 363A00000X · Licence 25MP00429700 (NJ)

Record details

NPI number1962936336
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedApril 12, 2017
Last updated in NPPESApril 12, 2017

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Eastern Pennsylvania Physician Alliance, Llc — 110 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Philadelphia