Dustin Derstine, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA066084 Issued in PA

Practice address

575 S 9TH St Ste 7
Lehighton, PA 18235-2517

Phone

(570) 645-1000

NPI assigned

Nov 26, 2024

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

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Luke'S Hospital 100 clinicians

St. Luke'S Hospital -Monroe Campus 53 clinicians

St. Luke'S Quakertown Hospital 33 clinicians

The Carbon-Schuylkill Community Hospital, Inc. 41 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dderstine243761@direct-sluhn.org

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.

• St. Luke'S Hospital

  • Urgent Care Clinic/Center
  • Bethlehem, PA
  • NPI 1740232719

  PA

  Medicare reassignment Care Compare group
• St. Luke'S Hospital Monroe Campus

  • Occupational Medicine Physician
  • Stroudsburg, PA
  • NPI 1609311257

  PA

  Medicare reassignment Care Compare group
• St. Luke'S Quakertown Hospital

  • Anatomic Pathology & Clinical Pathology Physician
  • Quakertown, PA
  • NPI 1225052616

  PA

  Medicare reassignment Care Compare group
• The Carbon-Schuylkill Community Hospital, Inc.

  • Emergency Medicine Physician
  • Coaldale, PA
  • NPI 1194891010

  PA

  Medicare reassignment Care Compare group
• GSL Hospital

  • Urgent Care Clinic/Center
  • Pottsville, PA
  • NPI 1073256608

  PA

  Medicare reassignment NPD
• St. Luke'S Hosptial

  • Urgent Care Clinic/Center
  • Wind Gap, PA
  • NPI 1376965731

  PA

  Medicare reassignment NPD
• St Lukes Hospital

  • General Acute Care Hospital
  • Bethlehem, PA
  • NPI 1013933175
  Care Compare group
• St Lukes Quakertown Hospital

  • General Acute Care Hospital
  • Quakertown, PA
  • NPI 1669405072
  Care Compare group
• St. Luke'S Hospital

  • Rehabilitation Hospital Unit
  • Bethlehem, PA
  • NPI 1073543120
  Care Compare group
• St. Luke'S Hospital

  • Obstetrics & Gynecology Physician
  • Bethlehem, PA
  • NPI 1508874538
  Care Compare group
• St. Luke'S Hospital

  • Psychiatric Hospital Unit
  • Allentown, PA
  • NPI 1750961629
  Care Compare group
• St. Luke'S Hospital Monroe Campus

  • General Acute Care Hospital
  • Stroudsburg, PA
  • NPI 1396194197
  Care Compare group

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

{
    "created_epoch": "1732579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1245056076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 S 9TH ST STE 7",
            "city": "LEHIGHTON",
            "state": "PA",
            "postal_code": "182352517",
            "telephone_number": "570-645-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 S 9TH ST STE 7",
            "city": "LEHIGHTON",
            "state": "PA",
            "postal_code": "182352517",
            "telephone_number": "570-645-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERSTINE",
        "first_name": "DUSTIN",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-26",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA066084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dematte Chiropractic Associates
• Dematte Chiropractic LLC
• John J Dematte IV, DC
• John J Dematte III, DC
• Shannon Dereamus, CRNP
• Timothy Joseph Donaghy, CRNP
• Nicholas Dorazio, DPT
• Dr Joseph McGinley PC
• Dr.L.Narayana Gajula & Associates
• Robert A Durako, DO

• All providers in Lehighton, PA
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.