Individual provider Active NPI

Paul H Abbott

  • Medical Physician Assistant
  • Butler, PA
National Provider Identifier
1114903093
Registry record updated Feb 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1035474 Issued in NU
Practice address
353 N Duffy Rd
Butler, PA 16001-1138
Phone
(878) 271-6035
Fax
(878) 271-6254
NPI assigned
Dec 21, 2005
Last updated
Feb 5, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1035474 NU Primary

Addresses

Primary practice location

353 N Duffy Rd
Butler, PA 16001-1138

Mailing address

353 North Dffy Road
Butler, PA 16001
Phone (878) 271-6035

Other identifiers 1

IdentifierTypeStateIssuer
004117700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549324800000",
    "number": "1114903093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 NORTH DFFY ROAD",
            "city": "BUTLER",
            "state": "PA",
            "postal_code": "16001",
            "telephone_number": "878-271-6035",
            "fax_number": "878-271-6254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 N DUFFY RD",
            "city": "BUTLER",
            "state": "PA",
            "postal_code": "160011138",
            "telephone_number": "878-271-6035",
            "fax_number": "878-271-6254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABBOTT",
        "first_name": "PAUL",
        "middle_name": "H",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2019-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": "1035474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004117700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Butler, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2019; 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.