Active NPI
David Paul Deysher, D.O.
- Gastroenterology Physician
- Lebanon, PA
National Provider Identifier
1164414678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- OS005373L
- Practice address
- 954 Isabel Dr
Lebanon, PA 17042-7482 - Phone
- (717) 376-1180
- Fax
- (717) 273-6937
- NPI assigned
- Aug 19, 2005
- Last updated
- Jan 2, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | OS005373L | PA | Primary |
Addresses
Primary practice location
954 Isabel Dr
Lebanon, PA 17042-7482
Mailing address
3421 Concord Rd
York, PA 17402-9001
Phone (717) 376-1180
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1512967 | Other | GATEWAY HEALTH PLAN | |
| 105170 | Other | HIGHMARK BLUE SHIELD | |
| 0010798740005 | Medicaid | PA | |
| 01554001 | Other | CAPITAL BLUE CROSS |
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
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Frederick Health Hospital
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1514851200000",
"number": "1164414678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3421 CONCORD RD",
"city": "YORK",
"state": "PA",
"postal_code": "174029001",
"telephone_number": "717-376-1180",
"fax_number": "717-273-6937"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "954 ISABEL DR",
"city": "LEBANON",
"state": "PA",
"postal_code": "170427482",
"telephone_number": "717-376-1180",
"fax_number": "717-273-6937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEYSHER",
"first_name": "DAVID",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-19",
"last_updated": "2018-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "PA",
"license": "OS005373L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GATEWAY HEALTH PLAN",
"identifier": "1512967",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "105170",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0010798740005",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUE CROSS",
"identifier": "01554001",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.