Active NPI
Philip Charles Devore, D.O.
- Family Medicine Physician
- North East, PA
National Provider Identifier
1366409062
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- BD8592594
- Practice address
- 115 E Main St
North East, PA 16428-1330 - Phone
- (814) 725-8774
- Fax
- (814) 725-2391
- NPI assigned
- Apr 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | BD8592594 | PA | Primary |
Addresses
Primary practice location
115 E Main St
North East, PA 16428-1330
Mailing address
115 E Main St
North East, PA 16428-1330
Phone (814) 725-8774
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013007010001 | Medicaid | PA | |
| DE1749598 | Other | PA | BLUE SHIELD/KEYSTONE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | philip.devore.do@nefp.amazing-direct.com | Direct |
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Lake Erie College of Osteopathic Medicine, Erie, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Keystone Rehabilitation Systems Inc
Practice addresses (Care Compare)
115 E Main St
North East, PA 16428-1330
Phone (814) 725-8774
5930 Old French Rd
Erie, PA 16509-3656
Phone (814) 860-7816
Hospital & facility affiliations
- Community Nursing Services of North East
- Community Nursing Services of North East
- Upmc Hamot
- Saint Vincent Hospital
- Lecom Medical Center and Behavioral Health Pav
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 16 |
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dudzinski Enterprises, Inc. | Family Medicine | Current | Accepting new patients |
Locations
115 E Main St
North East, PA 16428
Phone (814) 725-8774
Interoperability endpoints
- philip.devore.do@nefp.amazing-direct.com
Organizations & group practices 1
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.
-
- Family Medicine Physician
- North East, PA
- NPI 1154490480
Hospital & facility affiliations 13
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- North East, PA
- NPI 1780687913
-
- General Acute Care Hospital
- Erie, PA
- NPI 1548263973
-
- Geriatric Medicine (Internal Medicine) Physician
- Erie, PA
- NPI 1831085356
Hospital
-
- General Acute Care Hospital
- Erie, PA
- NPI 1861435042
-
- General Acute Care Hospital
- Erie, PA
- NPI 1487647590
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663113600000",
"number": "1366409062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 E MAIN ST",
"city": "NORTH EAST",
"state": "PA",
"postal_code": "164281330",
"telephone_number": "814-725-8774",
"fax_number": "814-725-2391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 E MAIN ST",
"city": "NORTH EAST",
"state": "PA",
"postal_code": "164281330",
"telephone_number": "814-725-8774",
"fax_number": "814-725-2391"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEVORE",
"first_name": "PHILIP",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-27",
"last_updated": "2022-09-14",
"certification_date": "2022-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "BD8592594",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1013007010001",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD/KEYSTONE",
"identifier": "DE1749598",
"state": "PA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "philip.devore.do@nefp.amazing-direct.com",
"affiliation": "N",
"endpointDescription": "direct message email address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "115 E Main St",
"city": "North East",
"state": "PA",
"country_code": "US",
"postal_code": "164281330",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in North East, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.
- 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.