NPIMap

Individual provider Active NPI

Tabatha L. Jeffers

  • Emergency Medicine Physician
  • Du Bois, PA
National Provider Identifier
1326058629
Registry record updated Jan 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS-010759-L Issued in PA
Practice address
100 Hospital Ave
Du Bois, PA 15801-1440
Phone
(814) 375-6470
Fax
(814) 375-3472
NPI assigned
Aug 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OS-010759-L PA Primary

Addresses

Primary practice location

100 Hospital Ave
Du Bois, PA 15801-1440

Mailing address

825 Treasure LK
Du Bois, PA 15801-9017
Phone (814) 375-0460

Other identifiers 2

IdentifierTypeStateIssuer
001608234OtherPAHIGHMARK BLUE CROSS
0019508010002MedicaidPA

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
I20050420000784 PA Practitioner - Emergency Medicine 7113977141 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Philadelphia College of Osteopathic Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brookville HospitalGroup PAC ID 3072579598, shared by 11 NPIs, 45 clinicians

Practice addresses (Care Compare)

100 Hospital Rd
Brookville, PA 15825-1367
Phone (814) 849-2312

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.6 of 100Reported as group
Promoting interoperability
96
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS-010759-LPAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brookville Hospital Emergency Medicine CurrentSince May 17, 2005 Accepting new patients
Elk Regional Health Center CurrentSince Apr 3, 2018 Accepting new patients
Brookville Hospital CurrentSince May 17, 2005 Accepting new patients
Dubois Regional Medical Center Emergency Medicine CurrentSince Feb 1, 2005 Accepting new patients
Dubois Regional Medical Center CurrentSince Feb 1, 2005 Accepting new patients
Elk Regional Health Center Emergency Medicine Current Accepting new patients
Elk Regional Health Center CurrentSince Apr 3, 2018 Accepting new patients
Brookville Hospital Emergency Medicine CurrentSince Apr 1, 2017 Accepting new patients
Clearfield Hospital Past Accepting new patients
Clearfield Hospital Emergency Medicine Past Accepting new patients

Locations

100 Hospital Rd
Brookville, PA 15825
Phone (814) 849-1408

809 Turnpike Ave
Clearfield, PA 16830
Phone (814) 765-5341

815 Doctors Dr
Ph
Clearfield, PA 16830
Phone (814) 205-1252

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

100 Hospital Ave
Ofc
Dubois, PA 15801

763 Johnsonburg Rd
Saint Marys, PA 15857
Phone (814) 788-8000

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Penn Highlands BrookvillePhilipsburg, PA, CCN 393430 Rural health clinic Other Jul 1, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 10

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 4

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

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422403200000",
    "number": "1326058629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 TREASURE LK",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158019017",
            "telephone_number": "814-375-0460",
            "fax_number": "814-375-3472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL AVE",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011440",
            "telephone_number": "814-375-6470",
            "fax_number": "814-375-3472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERS",
        "first_name": "TABATHA",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2015-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS-010759-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE CROSS",
            "identifier": "001608234",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019508010002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Du Bois, PA

Sources for this page

Verify at the official NPI Registry.