DUBOIS REGIONAL MEDICAL GROUP, PC (NPI# 1760786834) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760786834 |
| Entity Type | Organization |
| Organization Name | DUBOIS REGIONAL MEDICAL GROUP, PC |
| Practice Address |
135 Midway Drive Suite B Du Bois PA 15801-3857 |
| Mailing Address |
100 Hospital Ave Du Bois PA 15801-1440 |
| Practice Telephone | 8143711771 |
| Practice Fax Number | 8143714417 |
| Mailing Telephone | 8143756560 |
| Mailing Fax Number | 8143722848 |
| Enumeration Date | 2011-01-05 |
| Last Update Date | 2015-03-23 |
| Authorized Official Name | JOHN S SUTIKA (PRESIDENT) |
| Authorized Official Telephone | 8143753385 |
| Authorized Official Credential | CPA |
| Is Organization Subpart | Y |
| Parent Organization Name | PENN HIGHLANDS DUBOIS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 100751931-0013 | 05 | |
| PA | HIGHMARK ASSIGNMENT ACCOUNT | 002564699 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780090811 | Dubois Regional Medical Group, PC | Physician Assistant | 761 Johnsonburg Rd, Suite 340, Saint Marys, PA 15857-3483 | 2014-07-09 |
| 1730498452 | Dubois Regional Medical Group, PC | Family Medicine | 20 Industrial Dr, Du Bois, PA 15801-3842 | 2010-09-29 |
| 1093956617 | Dubois Regional Medical Group, PC | Nurse Practitioner | 100 Hospital Ave, Du Bois, PA 15801-1440 | 2009-03-11 |
| 1770741456 | Dubois Regional Medical Group, PC | Nurse Practitioner | 1033 Turnpike Ave, Suite 200, Clearfield, PA 16830-3061 | 2008-05-29 |
| 1598970949 | Dubois Regional Medical Group, PC | Internal Medicine | 807 Doctors Dr, Clearfield, PA 16830-1240 | 2007-05-11 |
| 1659467199 | Dubois Regional Medical Group, PC | Physician Assistant | 865 Beaver Dr, Du Bois, PA 15801-2511 | 2006-10-04 |
| 1285728915 | Dubois Regional Medical Group, PC | Family Medicine | 529 Sunflower Dr, Du Bois, PA 15801-2378 | 2006-10-03 |
| 1609960251 | Dubois Regional Medical Group, PC | Physician Assistant | 2834 Maplevale Rd, Brookville, PA 15825-2318 | 2006-10-03 |
| Street Address |
135 MIDWAY DRIVE SUITE B |
| City | DU BOIS |
| State | PA |
| Zip Code | 15801-3857 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215551452 | Grace Polohonki | Counselor | 490 Jefers Street, Dubois, PA 15801 | 2020-06-03 |
| 1144869231 | Richard Lee Kerstetter II | Hearing Instrument Specialist | 124 San Juan Rd, Du Bois, PA 15801 | 2020-01-06 |
| 1700368487 | Holly Noel Knoll | Counselor | 490 Jeffers Street, Dubois, PA 15801 | 2018-08-30 |
| 1992298160 | Dubois Regional Medical Center | Family Medicine | 145 Hospital Ave Ste 315, Du Bois, PA 15801 | 2018-06-12 |
| 1154814846 | Sara Beth Stone | Dietitian, Registered | 16288 Treasure Lk, Du Bois, PA 15801 | 2018-06-07 |
| 1942790779 | Wendi Dawn Wenzel | Counselor | 490 Jeffers St., Dubois, PA 15801 | 2018-05-17 |
| 1144748443 | Nancy Foradora | Massage Therapist | 200 Narrows Creek Park Road, Dubois, PA 15801 | 2017-09-07 |
| 1679098891 | Deborah Jean Mitchell | Hearing Instrument Specialist | 900 Beaver Drive, Dubois, PA 15801 | 2017-08-09 |
| 1861937757 | Shaun M Kanouff | Counselor | 100 Caldwell Dr., Dubois, PA 15801 | 2016-12-30 |
| 1164897740 | Drayer Physical Therapy Institute LLC | Physical Therapist | 873 Beaver Drive, Dubois, PA 15801 | 2015-12-08 |
| Find all providers in zip 15801 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770503583 | Naehal Patel Marra | Pediatrics | 135b Midway Dr, Du Bois, PA 15801-3857 | 2006-07-21 |
| 1336129220 | Desiree M. Webb | Pediatrics | 529 Sunflower Dr, Du Bois, PA 15801-2378 | 2006-01-18 |
| 1639174055 | W. John Siar | Pediatrics | 635c Maple Ave, Du Bois, PA 15801-2377 | 2005-06-14 |
| 1659938538 | Yin Yin Htun | Pediatrics | 100 Hospital Ave, Du Bois, PA 15801-1440 | 2019-05-25 |
| 1669621363 | Fatima Nadia Malik | Pediatrics | 529 Sunflower Dr, Du Bois, PA 15801-2378 | 2008-09-17 |
| 1114036084 | George M Fatula | Pediatrics | 529 Sunflower Dr, Du Bois, PA 15801-2378 | 2006-08-30 |
| 1104881648 | Gateway Area Medical PCp | Pediatrics | 635c Maple Ave, Du Bois, PA 15801-2377 | 2006-04-18 |
| 1356319149 | Marcy A. Hartle | Pediatrics | 865 Beaver Dr, Du Bois, PA 15801 | 2006-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093321622 | St Luke's Physician Group Inc | Pediatrics | 514 Delaware Ave, Fountain Hill, PA 18015-1104 | 2020-09-18 |
| 1972138204 | Margarita Bello | Pediatrics | 448 Walton Ave Unit 217, Hummelstown, PA 17036-4010 | 2020-03-06 |
| 1548809494 | Childen's Community Care | Pediatrics | 1811 Boulevard of The Allies Ste 200, Pittsburgh, PA 15219-5964 | 2019-12-24 |
| 1164069241 | Ayala Laufer-cahana | Pediatrics | 647 Montgomery School Ln, Wynnewood, PA 19096-1013 | 2019-12-08 |
| 1023652708 | Pediatric Care Group, P.C. | Pediatrics | 890 2nd Street Pike Ste 904, Richboro, PA 18954-1021 | 2019-11-05 |
| 1861036279 | Stc Pediatrics LLC | Pediatrics | 300 E Hunting Park Ave, Philadelphia, PA 19124-6018 | 2019-10-30 |
| 1679115760 | Rural Health Corporation of Northeastern Pennsylvania | Pediatrics | 1730 E Broad St Ste 2, Hazleton, PA 18201-5657 | 2019-10-10 |
| 1003462797 | Lucyndia Rose Marino | Pediatrics | 130 Classic Ln, New Castle, PA 16105-5304 | 2019-08-18 |
| 1861048803 | Geisinger Clinic | Pediatrics | 55 Medical Drive, Lewisburg, PA 17837-6343 | 2019-08-15 |
| 1447818729 | Elizabeth Edmondston Tarr | Pediatrics | 3401 Civic Center Blvd Fl 9nw55, Philadelphia, PA 19104-4319 | 2019-06-03 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.