Eric C Decker (NPI# 1912442666, PAC ID# 1052688041) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1912442666 |
| PAC ID by PECOS | 1052688041 |
| Professional Enrollment ID | I20170523000754 |
| Full Name | Eric C Decker |
| Organization Legal Name | CHILDRENS CENTER FOR TREATMENT AND EDUCATION |
| Address |
613 Elm St Tionesta PA 16353-9751 |
| Phone Number | 8148171400 |
| Gender | M |
| Graduation Year | 2016 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 4880750017 |
| Number of Group Practice Members | 8 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 390146 | WARREN GENERAL HOSPITAL |
| 390104 | KANE COMMUNITY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 800 E Main St, Bradford, PA 16701-3278 | 8148171400 | CHILDRENS CENTER FOR TREATMENT AND EDUCATION |
| 613 Elm St, Tionesta, PA 16353-9751 | 8148171400 | CHILDRENS CENTER FOR TREATMENT AND EDUCATION |
| Organization Legal Name | CHILDRENS CENTER FOR TREATMENT AND EDUCATION |
| Physicians | 9 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kerry E Bussoletti | Physician Assistant | Childrens Center for Treatment and Education | 613 Elm St, Tionesta, PA 16353-9751 |
| Deanann Farris | Psychiatry | Childrens Center for Treatment and Education | 613 Elm St, Tionesta, PA 16353-9751 |
| John P. John | Psychiatry | Childrens Center for Treatment and Education | 613 Elm St, Tionesta, PA 16353-9751 |
| Kathleen T Patterson | Nurse Practitioner | Childrens Center for Treatment and Education | 613 Elm St, Tionesta, PA 16353-9751 |
| Karen Ashbaugh | Clinical Social Worker | Childrens Center for Treatment and Education | 613 Elm St, Tionesta, PA 16353-9751 |
| John F Simora | Psychiatry | Childrens Center for Treatment and Education | 613 Elm St, Tionesta, PA 16353-9751 |
| Richard S Barton | Nurse Practitioner | Childrens Center for Treatment and Education | 613 Elm St, Tionesta, PA 16353-9751 |
| Kelly C Allen | Nurse Practitioner | Childrens Center for Treatment and Education | 613 Elm St, Tionesta, PA 16353-9751 |
| Street Address |
613 ELM ST |
| City | TIONESTA |
| State | PA |
| Zip | 16353-9751 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kerry E Bussoletti | Physician Assistant | Childrens Center for Treatment and Education | 613 Elm St, Tionesta, PA 16353-9751 |
| Deanann Farris | Psychiatry | Childrens Center for Treatment and Education | 613 Elm St, Tionesta, PA 16353-9751 |
| John P. John | Psychiatry | Childrens Center for Treatment and Education | 613 Elm St, Tionesta, PA 16353-9751 |
| Kathleen T Patterson | Nurse Practitioner | Childrens Center for Treatment and Education | 613 Elm St, Tionesta, PA 16353-9751 |
| Karen Ashbaugh | Clinical Social Worker | Childrens Center for Treatment and Education | 613 Elm St, Tionesta, PA 16353-9751 |
| John F Simora | Psychiatry | Childrens Center for Treatment and Education | 613 Elm St, Tionesta, PA 16353-9751 |
| Richard S Barton | Nurse Practitioner | Childrens Center for Treatment and Education | 613 Elm St, Tionesta, PA 16353-9751 |
| Kelly C Allen | Nurse Practitioner | Childrens Center for Treatment and Education | 613 Elm St, Tionesta, PA 16353-9751 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lara K Johnson | Physician Assistant | Titusville Area Health Services, Inc. | 111 Bridge St, Tionesta, PA 16353-9737 |
| Constantine M Dy | Family Medicine | Titusville Area Health Services, Inc. | 111 Bridge St, Tionesta, PA 16353-9737 |
| City | TIONESTA |
| Zip Code | 16353 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | TIONESTA + PHYSICIAN ASSISTANT |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.