NPIMap

Individual provider Active NPI

Dora Blair Nelson, PA-C

  • Physician Assistant
  • Saint Marys, PA
National Provider Identifier
1114764750
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA065568 Issued in PA
Practice address
761 Johnsonburg Rd
Saint Marys, PA 15857-3483
Phone
(814) 512-7126
NPI assigned
Jul 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA065568 PA Primary

Addresses

Primary practice location

761 Johnsonburg Rd
Saint Marys, PA 15857-3483

Mailing address

326 Terra Cotta Rd
Johnsonburg, PA 15845-1050
Phone (814) 512-7126

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
I20241015003585 PA Practitioner - Physician Assistant 5597297572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dubois Regional Medical CenterGroup PAC ID 5890689715, 424 clinicians

Practice addresses (Care Compare)

145 Hospital Ave
Suite 315
Du Bois, PA 15801-1465
Phone (814) 503-4305

761 Johnsonburg Rd
Suite 160
Saint Marys, PA 15857-3484
Phone (814) 788-8777

Hospital & facility affiliations

  • Penn Highlands Dubois Hospital, Dubois, PA, CCN 390086
  • Penn Highlands Elk Hospital, Saint Marys, PA, CCN 391315

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA065568PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dubois Regional Medical Center Physician Assistant CurrentSince Aug 23, 2024 Accepting new patients
Dubois Regional Medical Center CurrentSince Aug 23, 2024 Accepting new patients
Dubois Regional Medical Center Physician Assistant Past Accepting new patients

Locations

100 Hospital Ave
Dubois, PA 15801
Phone (814) 375-2040

250 W Main St
Ridgway, PA 15853
Phone (814) 772-8122

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 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1114764750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 TERRA COTTA RD",
            "city": "JOHNSONBURG",
            "state": "PA",
            "postal_code": "158451050",
            "telephone_number": "814-512-7126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "761 JOHNSONBURG RD",
            "city": "SAINT MARYS",
            "state": "PA",
            "postal_code": "158573483",
            "telephone_number": "814-512-7126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "DORA",
        "middle_name": "BLAIR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-11",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA065568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Marys, PA

Sources for this page

Verify at the official NPI Registry.