Active NPI
Chad J. Demarche, PA
- Physician Assistant
- Watertown, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 016396
- Practice address
- 830 Washington St
Watertown, NY 13601-4034 - Phone
- (315) 788-1751
- Fax
- (315) 788-9021
- NPI assigned
- Oct 12, 2012
- Last updated
- May 9, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 016396 | NY | Primary |
Addresses
Primary practice location
830 Washington St
Watertown, NY 13601-4034
Mailing address
830 Washington St
Watertown, NY 13601-4034
Phone (315) 788-1751
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03583451 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10881 US Route 11
Adams, NY 13605-3154
Phone (315) 232-4400
629 Washington St
Watertown, NY 13601-4836
Phone (315) 755-3451
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016396 | NY | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Samaritan Medical Center | Current | Accepting new patients | |
| New York Anesthesiology Medical Specialties, PC | Past | Accepting new patients | |
| Watertown Ear Nose and Throat GRP | Past | Accepting new patients | |
| Samaritan Medical Center | Past | Accepting new patients | |
| Syracuse Orthopedic Specialists, PLLC | Past | Accepting new patients |
Locations
830 Washington St
Watertown, NY 13601
Phone (315) 785-4000
Interoperability endpoints
- cdemarche@samaritanmedicalpractice.medentdirect.com
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.
-
- General Acute Care Hospital
- Watertown, NY
- NPI 1598713745
-
- Psychiatric Hospital Unit
- Watertown, NY
- NPI 1801902713
-
dba New York Spine and Wellness Center
- Durable Medical Equipment & Medical Supplies
- Camillus, NY
- NPI 1023497203
-
- Orthopaedic Surgery Physician
- Syracuse, NY
- NPI 1669410379
-
- Otolaryngology Physician
- Watertown, NY
- NPI 1407948011
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Watertown, NY
- NPI 1598713745
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715212800000",
"number": "1780936872",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "830 WASHINGTON ST",
"city": "WATERTOWN",
"state": "NY",
"postal_code": "136014034",
"telephone_number": "315-788-1751",
"fax_number": "315-788-9021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "830 WASHINGTON ST",
"city": "WATERTOWN",
"state": "NY",
"postal_code": "136014034",
"telephone_number": "315-788-1751",
"fax_number": "315-788-9021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMARCHE",
"first_name": "CHAD",
"middle_name": "J.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-10-12",
"last_updated": "2024-05-09",
"certification_date": "2024-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "016396",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03583451",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Watertown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; 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.