Demetrios Joanow, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA063809 Issued in PA

Practice address

40 Horizon Farms Dr
Warwick, NY 10990-2260

Phone

(845) 258-0129

NPI assigned

May 6, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Childrens Health Care Associates of New Jersey PC

  • Pediatrics Physician
  • Voorhees, NJ
  • NPI 1427152917
  NPD (past)

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

{
    "created_epoch": "1651795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671840000000",
    "number": "1356087019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 HORIZON FARMS DR",
            "city": "WARWICK",
            "state": "NY",
            "postal_code": "109902260",
            "telephone_number": "845-258-0129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 HORIZON FARMS DR",
            "city": "WARWICK",
            "state": "NY",
            "postal_code": "109902260",
            "telephone_number": "845-258-0129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOANOW",
        "first_name": "DEMETRIOS",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-06",
        "last_updated": "2022-12-24",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA063809",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iammatteo Family Chiropractic PLLC
• Susan M Isaacson
• Julia K Jeong, DMD, MS
• Jessica M Comerford Acupuncture PLLC
• Jo L. Vanderkloot LCSW, P.C.
• John a. Ferro, M.D., P.C.
• Delna M Joseph, LPN
• Journey Life Balance Inc
• John Stephen Juliano, M.D.
• Christine Jurgensen

• Physician Assistant in Warwick, NY
• Providers in Warwick, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.