Individual provider Active NPI

Dustin Samuel Hobbs, PA-C

  • Surgical Physician Assistant
  • Wilkes Barre, PA
National Provider Identifier
1417266255
Registry record updated Nov 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
OA002624 Issued in PA
Practice address
110 S Pennsylvania Ave
Wilkes Barre, PA 18701-3301
Phone
(570) 552-6000
Fax
(570) 552-6021
NPI assigned
Sep 28, 2010
Last updated
Nov 17, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA054634 PA
Surgical Physician Assistant 363AS0400X OA002624 PA Primary

Addresses

Primary practice location

110 S Pennsylvania Ave
Wilkes Barre, PA 18701-3301

Mailing address

220 S River St
Plains, PA 18705-1137
Phone (570) 824-8151

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
I20110119000749 PA Practitioner - Physician Assistant 8527247865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nepa Family Practice PLLCGroup PAC ID 6204239213, 2 clinicians

Practice addresses (Care Compare)

220 River Rd
Suite 200
Plains, PA 18705-1137
Phone (570) 824-8151

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wilkes-Barre Behavioral Hospital Company LLC Physician Assistant Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dhobbs@nepafamilypractice.medentdirect.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1285632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479340800000",
    "number": "1417266255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 S RIVER ST",
            "city": "PLAINS",
            "state": "PA",
            "postal_code": "187051137",
            "telephone_number": "570-824-8151",
            "fax_number": "570-824-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S PENNSYLVANIA AVE",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187013301",
            "telephone_number": "570-552-6000",
            "fax_number": "570-552-6021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOBBS",
        "first_name": "DUSTIN",
        "middle_name": "SAMUEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-28",
        "last_updated": "2016-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA054634",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "OA002624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.