NPIMap

Organization Active NPI

Dubois Regional Medical Group, PC

  • Multi-Specialty Clinic/Center
  • Du Bois, PA
National Provider Identifier
1285728915
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
DUBOIS REGIONAL MEDICAL GROUP, PC
Practice address
529 Sunflower Dr
Du Bois, PA 15801-2378
Phone
(814) 375-6560
Fax
(814) 372-2848
NPI assigned
Oct 3, 2006
Last updated
Dec 20, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
PENN HIGHLANDS HEALTHCAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Authorized official

Name
Mr. John S Sutika
Title
Authorized Official & Secretary
Phone
(814) 375-3385

Specialties & licenses 13

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary
Physician Assistant 363A00000X
Nurse Practitioner 363L00000X
Family Medicine Physician 207Q00000X
Addiction Medicine (Family Medicine) Physician 207QA0401X PA
Neurological Surgery Physician 207T00000X
Obstetrics & Gynecology Physician 207V00000X PA
Otolaryngology Physician 207Y00000X
Pediatric Cardiology Physician 2080P0202X
Surgery Physician 208600000X
Plastic and Reconstructive Surgery Physician 2086S0122X PA
Podiatrist 213E00000X
Obesity Medicine (Internal Medicine) Physician 207RB0002X

Addresses

Primary practice location

529 Sunflower Dr
Du Bois, PA 15801-2378

Mailing address

100 Hospital Ave
Du Bois, PA 15801-1440
Phone (814) 375-6566

Other identifiers 2

IdentifierTypeStateIssuer
100751931MedicaidPA
063246OtherPAMEDICARE

Other names 1

  • DRMG Multi-Specialty Practice Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040119000522 PA Part B Supplier - Clinic/Group Practice 8022917269 Receives reassigned benefits from 46 practitioners
4 other NPIs on this enrollment
Practice locations: Monongahela, PA; Tyrone, PA; Philipsburg, PA; Punxsutawney, PA; Saint Marys, PA; St Mary, PA; St Marys, PA; State College, PA…

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Penn Highlands Healthcare

Locations

807 Doctors Dr
#1894
Clearfield, PA 16830
Phone (814) 375-3711

820 Bryan St
Huntingdon, PA 16652
Phone (814) 375-6560

761 Johnsonburg Rd
Ste 210
Saint Marys, PA 15857
Phone (814) 781-8655

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 52

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 52

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639958400000",
    "number": "1285728915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL AVE",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011440",
            "telephone_number": "814-375-6566",
            "fax_number": "814-372-2848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 SUNFLOWER DR",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158012378",
            "telephone_number": "814-375-6560",
            "fax_number": "814-372-2848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUBOIS REGIONAL MEDICAL GROUP, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PENN HIGHLANDS HEALTHCARE",
        "enumeration_date": "2006-10-03",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A",
        "authorized_official_last_name": "SUTIKA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL & SECRETARY",
        "authorized_official_telephone_number": "814-375-3385",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RB0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100751931",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "063246",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DRMG Multi-Specialty Practice",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "DRMG Multi-Specialty Practice",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Du Bois, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.