DEMIANA ATTALLAH (PA) – Physician Assistant, NPI 1164104717

DEMIANA ATTALLAH (PA) is a healthcare provider. based in Vero beach, Florida. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 5495 (TN). The NPI Number for DEMIANA ATTALLAH (PA) is 1164104717

Main info

Female
Sole Proprietor
4 Years Of Experience
Accepts Medicare Assignment
Name
DEMIANA ATTALLAH (PA)
NPI
1164104717
Phone
Not provided
Address
1701 HIGHWAY A1A STE 300
Enumeration Date
3 August 2023
Last Update Date
2 June 2026

Doctor Profile

Medical School Name
UNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
Secondary Phone
8663892727
Graduation Year
2022 (4 years ago)
PAC ID
9830552819
Group Practice PAC ID
2961428990
Professional Enrollment ID
I20230823002761
Address ID
TN372114357NA735XXPLXX300
Data current as of
10 June 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness85
Years active:2State licenses:1Digital endpointsOther names

3,134 PHYSICIAN ASSISTANT in TN

Provider Addresses for DEMIANA ATTALLAH (PA)

  • 1701 HIGHWAY A1A STE 300

    VERO BEACH, FL 329632263

    Phone:

    Type: Mailing

  • 4230 HARDING PIKE STE 1005

    NASHVILLE, TN 372052013

    Phone: (615) 964-5823

    Type: Location

  • 101 Otis Smith Dr Ste B

    Clarksville, TN 370438940

    Phone: (615) 964-5823

    Type: Location

  • 10101 Ramsey Way # 14

    Dickson, TN 370551085

    Phone: (615) 964-5823

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-08-23

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230823002761IPhysician AssistantTNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32963)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2961428990View full group profile

Reviews

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Frequently asked questions

What federal number belongs to DEMIANA ATTALLAH (PA)?
The federal identifier for DEMIANA ATTALLAH (PA) is NPI 1164104717.
Is DEMIANA ATTALLAH (PA)'s NPI currently valid?
The extract we use shows DEMIANA ATTALLAH (PA) as active.
Can you summarize DEMIANA ATTALLAH (PA)'s specialty in plain language?
Clinically, the directory lists DEMIANA ATTALLAH (PA) with Physician Assistant. Clinical services aligned with this taxonomy classification.
Does DEMIANA ATTALLAH (PA) practice in Florida?
You will see Vero Beach, Florida on file for DEMIANA ATTALLAH (PA) alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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