Dubois Regional Medical Group, PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

DUBOIS REGIONAL MEDICAL GROUP, PC

Practice address

123 Hospital Ave
Dubois, PA 15801-2428

Phone

(814) 371-1510

Fax

(814) 371-2922

NPI assigned

Oct 4, 2006

Last updated

Nov 9, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

PENN HIGHLANDS DUBOISAs reported in NPPES

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

Authorized official

Name

John S Sutika, CPA

Title

President

Phone

(814) 375-3385

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Dubois Regional Medical Group, PC

  • Family Medicine Physician
  • Du Bois, PA
  • NPI 1093956617

  O20040119000522

  Same enrollment
• Dubois Regional Medical Group, PC

  • Multi-Specialty Clinic/Center
  • Du Bois, PA
  • NPI 1285728915

  O20040119000522

  Same enrollment
• Dubois Regional Medical Group, PC

  • Pediatrics Physician
  • Brookville, PA
  • NPI 1609960251

  O20040119000522

  Same enrollment

Part of

Dubois Regional Medical Center - Penn Highlands Family Medicine

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/N7LD0qx6O97vWG2K68nV0s0G4Xzq2rtM/

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667952000000",
    "number": "1659467199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL AVE",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011440",
            "telephone_number": "814-375-6560",
            "fax_number": "814-372-2848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 HOSPITAL AVE",
            "city": "DUBOIS",
            "state": "PA",
            "postal_code": "158012428",
            "telephone_number": "814-371-1510",
            "fax_number": "814-371-2922"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "865 Beaver Dr",
            "address_purpose": "LOCATION",
            "city": "Du Bois",
            "state": "PA",
            "postal_code": "158012511",
            "country_code": "US",
            "telephone_number": "814-371-1510",
            "fax_number": "814-371-2922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DUBOIS REGIONAL MEDICAL GROUP, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PENN HIGHLANDS DUBOIS",
        "enumeration_date": "2006-10-04",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-07",
        "status": "A",
        "authorized_official_last_name": "SUTIKA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "814-375-3385",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK ASSIGNMENT ACCOUNT",
            "identifier": "001358073",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007519310001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007519310007",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dubois Regional Medical Center - Penn Highlands Dubois Medical Arts (Pennn Highlands DuBois)
• Dubois Regional Medical Center - Penn Highlands Family Medicine (Penn Highlands DuBois)
• Dubois Regional Medical Center - Penn Highlands Q-Care Dubois (Penn Highlands DuBois)
• Dubois Regional Medical Group, PC
• Dubois Regional Medical Group, PC
• Dubois Regional Medical Group, PC
• Dubois Vision Clinic
• John E. Dubois III, D.C.
• Rebecca Ann Durian, NP-C
• Dva Healthcare Renal Care Inc (Dubois Dialysis)

• Pediatrics Physician in Du Bois, PA
• Providers in Du Bois, PA by specialty
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.