Individual provider Active NPI

Megan E Pistner, PA-C

  • Physician Assistant
  • Du Bois, PA
National Provider Identifier
1770893141
Registry record updated Oct 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA054478 Issued in PA
Practice address
635 Maple Ave
Du Bois, PA 15801-2376
Phone
(814) 375-6379
Fax
(814) 375-9320
NPI assigned
Oct 19, 2010
Last updated
Oct 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2021

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 NU
Physician Assistant 363A00000X MA054478 PA Primary

Addresses

Primary practice location

635 Maple Ave
Du Bois, PA 15801-2376

Mailing address

100 Hospital Ave
Du Bois, PA 15801-1440
Phone (814) 375-6379

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
I20110926000069 PA Practitioner - Physician Assistant 7517136195 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA054478PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Brookville Hospital Physician Assistant CurrentSince Jul 1, 2016 Accepting new patients
Keystone Rural Health Consortia, Inc. CurrentSince May 6, 2024 Accepting new patients
Brookville Hospital CurrentSince Jul 1, 2016 Accepting new patients
Keystone Rural Health Consortia Inc Past Accepting new patients
Keystone Rural Health Consortia, Inc. Past Accepting new patients

Locations

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

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

90 E 2nd St
Emporium, PA 15834
Phone (814) 486-0909

49 Ridgmont Dr
#1
Ridgway, PA 15853
Phone (814) 245-2119

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1287446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633651200000",
    "number": "1770893141",
    "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": "814-375-6379",
            "fax_number": "814-375-9320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 MAPLE AVE",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158012376",
            "telephone_number": "814-375-6379",
            "fax_number": "814-375-9320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PISTNER",
        "first_name": "MEGAN",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-19",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA054478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Du Bois, PA

Sources for this page

Verify at the official NPI Registry.