NPIMap

Individual provider Active NPI

Mariah L. Shimmel, PA-C

  • Physician Assistant
  • Du Bois, PA
National Provider Identifier
1467933713
Registry record updated Dec 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
OA004591 Issued in PA
Practice address
145 Hospital Ave
Du Bois, PA 15801-1462
Phone
(814) 375-2200
NPI assigned
Aug 24, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2022

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 MA060061 PA
Physician Assistant 363A00000X OA004591 PA Primary

Addresses

Primary practice location

145 Hospital Ave
Du Bois, PA 15801-1462

Mailing address

145 Hospital Ave
Du Bois, PA 15801-1462
Phone (814) 375-2200

Other names 1

  • Mariah Lynn Sanderbeck Former name

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
I20181025002099 PA Practitioner - Physician Assistant 7012260771 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dubois Regional Medical CenterGroup PAC ID 5890689715, 424 clinicians
Brookville HospitalGroup PAC ID 3072579598, 45 clinicians

Practice addresses (Care Compare)

145 Hospital Ave
Suite 315
Du Bois, PA 15801-1465
Phone (814) 503-4305

1900 River Rd
Clearfield, PA 16830-6026
Phone (814) 205-1250

271 Railroad St
Philipsburg, PA 16866-2300
Phone (814) 342-9701

Hospital & facility affiliations

  • Penn Highlands Dubois Hospital, Dubois, PA, CCN 390086

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA060061PAMDPhysician Assistant
OA004591PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Brookville Hospital Physician Assistant CurrentSince Oct 15, 2022 Accepting new patients
Dubois Regional Medical Center Physician Assistant CurrentSince Oct 15, 2022 Accepting new patients
Brookville Hospital Physician Assistant CurrentSince Oct 15, 2022 Accepting new patients
Dubois Regional Medical Center CurrentSince Oct 15, 2022 Accepting new patients

Locations

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

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

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1535068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1467933713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 HOSPITAL AVE",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011462",
            "telephone_number": "814-375-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 HOSPITAL AVE",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011462",
            "telephone_number": "814-375-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIMMEL",
        "first_name": "MARIAH",
        "middle_name": "L.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-24",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA060061",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA004591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIAH",
            "last_name": "SANDERBECK",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Du Bois, PA

Sources for this page

Verify at the official NPI Registry.