Individual provider Active NPI

Pamela T Demnicki, MD

  • Surgery Physician
  • West Chester, PA
National Provider Identifier
1528066032
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD060771L Issued in PA
Practice address
915 Old Fern Hill Road
Building B, Suite 201
West Chester, PA 19380-3431
Phone
(610) 436-6696
Fax
(610) 430-6023
NPI assigned
Jul 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X C10005645 DE
Surgery Physician 208600000X MD060771L PA Primary

Addresses

Primary practice location

915 Old Fern Hill Road
Building B, Suite 201
West Chester, PA 19380-3431

Mailing address

915 Old Fern Hill Rd
Building B, Suite 201
West Chester, PA 19380-4269
Phone (610) 436-6696

Other identifiers 1

IdentifierTypeStateIssuer
0000942301MedicaidDE

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100517000012 PA Practitioner - General Surgery 3971699661 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

701 E Marshall St
West Chester, PA 19380-4412

777 Township Line Rd
Suite 200
Yardley, PA 19067-5564
Phone (215) 860-0775

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy11
Hernia repair - groin (open)26
Hernia repair (minimally invasive)35
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C10005645DEMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Surgical Specialists, P.C. Surgery CurrentSince Feb 16, 2010 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Mar 10, 2020 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Syst Surgery CurrentSince Mar 10, 2020 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Current Accepting new patients
Chester County Hospital Past Accepting new patients

Locations

404 McFarlan Rd
Ste 101
Kennett Square, PA 19348
Phone (610) 925-3835

255 W Lancaster Ave
Ste 332
Paoli, PA 19301
Phone (610) 641-9011

915 Old Fern Hill Rd
Bldg D
West Chester, PA 19380
Phone (610) 235-4100

915 Old Fern Hill Rd
Bldg B
West Chester, PA 19380
Phone (610) 696-1230

915 Old Fern Hill Rd
Ste 201
West Chester, PA 19380
Phone (610) 436-6696

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

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.

Hospital & facility affiliations 3

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": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1528066032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 OLD FERN HILL RD",
            "address_2": "BUILDING B, SUITE 201",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193804269",
            "telephone_number": "610-436-6696",
            "fax_number": "610-430-6023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 OLD FERN HILL ROAD",
            "address_2": "BUILDING B, SUITE 201",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193803431",
            "telephone_number": "610-436-6696",
            "fax_number": "610-430-6023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMNICKI",
        "first_name": "PAMELA",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-08",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "DE",
            "license": "C10005645",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD060771L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000942301",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chester, PA

Sources for this page

Verify at the official NPI Registry.