Joshua Michael Dearth, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9110420 Issued in FL

Practice address

151 Pine Lake Dr Unit B
Ponte Vedra, FL 32081-5136

Phone

(904) 543-3677

NPI assigned

Sep 23, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Solantic of Jacksonville LLCGroup PAC ID 1052409307, 56 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Solantic of Jacksonville, LLC

  • Urgent Care Clinic/Center
  • Ponte Vedra, FL
  • NPI 1407893100
  Medicare reassignment Care Compare group
• Middletown Emergency Physicians, Inc.

  • Emergency Medicine Physician
  • Franklin, OH
  • NPI 1932108784
  NPD (past)

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

{
    "created_epoch": "1411430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587600000000",
    "number": "1528460425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 PINE LAKE DRIVE",
            "address_2": "SUITEB",
            "city": "POINTE VEDRA",
            "state": "FL",
            "postal_code": "320812584",
            "telephone_number": "904-543-3677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 PINE LAKE DR UNIT B",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320815136",
            "telephone_number": "904-543-3677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "OH",
            "postal_code": "450052584",
            "country_code": "US",
            "telephone_number": "513-705-4038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEARTH",
        "first_name": "JOSHUA",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-23",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9110420",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50-004097",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Carla Marie Defuria, MBA, RDN, LDN
• Sherry Dianne Dekeyser, M.D.
• Deliver PT, LLC
• Charles Michael Dellinger, PHARM.D.
• Debra Depto, PT

• Physician Assistant in Ponte Vedra, FL
• Providers in Ponte Vedra, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2020; 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.

Verify at the official NPI Registry.