Individual provider Active NPI

Emily Rae Bish, PA-C

  • Medical Physician Assistant
  • Du Bois, PA
National Provider Identifier
1356676233
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA053920 Issued in PA
Practice address
123 Hospital Avenue
Du Bois, PA 15801-1409
Phone
(814) 371-1510
Fax
(814) 371-2922
NPI assigned
Oct 9, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA053920 PA Primary

Addresses

Primary practice location

123 Hospital Avenue
Du Bois, PA 15801-1409

Mailing address

100 Hospital Ave
Du Bois, PA 15801-1440
Phone (814) 371-1510

Other names 1

  • Emily Rae Sedlock Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100112000607 PA Practitioner - Physician Assistant 1153462171 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA053920PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dubois Regional Medical Group, PC CurrentSince Sep 6, 2022 Accepting new patients
Dubois Regional Medical Center CurrentSince Jun 6, 2022 Accepting new patients
Dubois Regional Medical Center Past Accepting new patients

Locations

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

123 Hospital Ave
Dubois, PA 15801
Phone (814) 371-1510

529 Sunflower Dr
Dubois, PA 15801
Phone (814) 371-1510

145 Hospital Ave
Ste 102
Dubois, PA 15801
Phone (814) 375-6510

Interoperability endpoints

  • Direct secure messaging: erbish@1285.direct.myezyaccess.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1255046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1356676233",
    "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": "814-371-1510",
            "fax_number": "814-371-2922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 HOSPITAL AVENUE",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011409",
            "telephone_number": "814-371-1510",
            "fax_number": "814-371-2922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISH",
        "first_name": "EMILY",
        "middle_name": "RAE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-09",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA053920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "SEDLOCK",
            "middle_name": "RAE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Du Bois, PA

Sources for this page

Verify at the official NPI Registry.