NPIMap

Individual provider Active NPI

Jon Derek Nicassio, DO

  • Family Medicine Physician
  • North Huntingdon, PA
National Provider Identifier
1083292585
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS023552 Issued in PA
Practice address
8791 Barnes Lake Rd Ste 101
North Huntingdon, PA 15642-3176
Phone
(724) 864-9400
Fax
(724) 864-8044
NPI assigned
Mar 29, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X OS023552 PA Primary

Addresses

Primary practice location

8791 Barnes Lake Rd Ste 101
North Huntingdon, PA 15642-3176

Mailing address

8791 Barnes Lake Rd Ste 101
North Huntingdon, PA 15642-3176
Phone (724) 864-9400

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jonnicassio@emg.allscriptsdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240625003874 PA Practitioner - Family Practice 8820499296 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia School of Osteopathic Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excela Health Physician Practices, IncGroup PAC ID 6204737117, 474 clinicians

Practice addresses (Care Compare)

100 Excela Health Dr
301 Excela Square Latrobe Family Medicine
Latrobe, PA 15650-9001
Phone (724) 537-1480

Hospital & facility affiliations

  • Allegheny Health Network Healthcare at Home Home H Home health agency, Warrendale, PA, CCN 398069
  • Excela Health Home Care & Hospice Home health agency, Greensburg, PA, CCN 397090
  • Excela Health Westmoreland Regional Hospital Hospital, Greensburg, PA, CCN 390145
  • Excela Health Latrobe Hospital Hospital, Latrobe, PA, CCN 390219

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS023552PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Excela Health Physician Practices, Inc. Family Medicine CurrentSince Aug 1, 2024 Accepting new patients
Excela Health Physician Practices, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Excela Health Physician Practices, Inc Multi-Specialty Current Accepting new patients

Locations

532 W Pittsburgh St
Greensburg, PA 15601
Phone (724) 832-4000

100 Excela Health Dr
Ste 301
Latrobe, PA 15650
Phone (724) 537-1480

8791 Barnes Lake Rd
Ste 101
North Huntingdon, PA 15642
Phone (724) 864-4996

Interoperability endpoints

  • Direct secure messaging: jonnicassio@emg.allscriptsdirect.net

Organizations & group practices 3

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.

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1083292585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8791 BARNES LAKE RD STE 101",
            "city": "NORTH HUNTINGDON",
            "state": "PA",
            "postal_code": "156423176",
            "telephone_number": "724-864-9400",
            "fax_number": "724-864-8044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8791 BARNES LAKE RD STE 101",
            "city": "NORTH HUNTINGDON",
            "state": "PA",
            "postal_code": "156423176",
            "telephone_number": "724-864-9400",
            "fax_number": "724-864-8044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICASSIO",
        "first_name": "JON",
        "middle_name": "DEREK",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-29",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS023552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jonnicassio@emg.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "EH Primary Care North Huntingdon Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "8791 Barnes Lake Rd Ste 101",
            "city": "North Huntingdon",
            "state": "PA",
            "country_code": "US",
            "postal_code": "156423176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in North Huntingdon, PA

Sources for this page

Verify at the official NPI Registry.