Paul Debacco, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD054772L Issued in PA

Practice address

1161 McDermott Dr.
Suite 101
West Chester, PA 19380-4042

Phone

(610) 701-7011

Fax

(610) 429-5199

NPI assigned

Jan 25, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319068800000",
    "number": "1013987783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1161 MCDERMOTT DR.",
            "address_2": "SUITE 101",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193804042",
            "telephone_number": "610-701-7011",
            "fax_number": "610-429-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1161 MCDERMOTT DR.",
            "address_2": "SUITE 101",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193804042",
            "telephone_number": "610-701-7011",
            "fax_number": "610-429-5199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBACCO",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2011-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD054772L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAIN LINE HEALTHCARE",
            "identifier": "232359401",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001541257",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Eileen Dawson
• Elizabeth Dayton
• Abby June De Meester
• Kathryn A Dearborn, CCC-SLP
• Jennifer Deardorff
• Debaptiste & Associates OB-GYN, P.C.
• Debbie Waterman, PHD, PC
• Elizabeth Paige Deberardinis, MS, CCC-SLP
• Mark Jeffrey Decker, M.D.
• Monica Ann Decker, CRNP

• Family Medicine Physician in West Chester, PA
• Providers in West Chester, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.