Michael E Fath, D.O., P.C

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS012073 Issued in PA

Legal business name

MICHAEL E FATH, D.O., P.C

Practice address

575 Pierce St Ste 101
Kingston, PA 18704-5700

Phone

(570) 718-8676

Fax

(570) 338-2345

NPI assigned

Mar 14, 2008

Organization subpart

No

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

Authorized official

Name

Michael E Fath, D.O.NPI 1487631214

Title

Ceo/President

Phone

(570) 718-8676

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael E Fath, D.O.

  • Family Medicine Physician
  • Kingston, PA
  • NPI 1487631214
  Medicare reassignment Care Compare group Authorized official
• Michael F Robatin, MSN, CRNP

  • Adult Health Nurse Practitioner
  • Kingston, PA
  • NPI 1649273574
  Medicare reassignment Care Compare group NPD
• David E Owens, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Kingston, PA
  • NPI 1669458808
  NPD (past)

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

{
    "created_epoch": "1205452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611273600000",
    "number": "1801067145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 PIERCE ST STE 101",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045700",
            "telephone_number": "570-338-2345",
            "fax_number": "570-718-8676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 PIERCE ST STE 101",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045700",
            "telephone_number": "570-718-8676",
            "fax_number": "570-338-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL E FATH, D.O., P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-14",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A",
        "authorized_official_last_name": "FATH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "570-718-8676",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS012073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1038359820001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMRK",
            "identifier": "4505879",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Joan Meehan
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• Carlo Anthony Mercadante, LAT, ATC
• William R Mericle, LCSW
• Leah Alexandra Merrick, PA-C
• Michael F. Lombard MD Stanley a. Lobitz MD Gen PTRS
• Michele Mattie, PHD, LLC
• Richard D Michelstein, M.D.
• Thomas Mickowski, CRNP
• Allison Middleton, LSW

• Family Medicine Physician in Kingston, PA
• Providers in Kingston, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; 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.