Sadie Ann Deckard, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601008575 Issued in MI

Practice address

1717 W Main St Ste 201
Newark, OH 43055

Phone

(220) 564-2900

Fax

(220) 564-2901

NPI assigned

Feb 6, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH, MI2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Licking Memorial Health Professionals 235 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Licking Memorial Hospital Hospital, Newark, OH, CCN 360218

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sdeckard572012@direct.hfhs.org

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.

• Licking Memorial Health Professionals

  • Family Medicine Physician
  • Newark, OH
  • NPI 1326072265

  OH

  Medicare reassignment Care Compare group NPD
• University Hospitals Conneaut Medical Center

  • Nurse Practitioner
  • Conneaut, OH
  • NPI 1831545177

  OH, Physician Assistant

  Medicare reassignment NPD
• Licking Memorial Professional Corporation

  • Durable Medical Equipment & Medical Supplies
  • Newark, OH
  • NPI 1326436510
  Care Compare group NPD
• University Hospitals Geneva Medical Center

  • Nurse Practitioner
  • Geneva, OH
  • NPI 1700261807

  OH

  Medicare reassignment
• Adrian Urgent Care PLLC

  • Family Medicine Physician
  • Adrian, MI
  • NPI 1003204769

  MI

  Medicare reassignment
• Wa Foote Memorial Hospital, Inc

  • Nurse Practitioner
  • Jackson, MI
  • NPI 1629000708

  MI

  Medicare reassignment
• University Hospitals Conneaut Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Conneaut, OH
  • NPI 1154408250
  NPD
• W.a. Foote Memorial Hospital, Inc

  • Nurse Practitioner
  • Jackson, MI
  • NPI 1366988347
  NPD
• W.a. Foote Memorial Hospital, Inc

  • Physician Assistant
  • Jackson, MI
  • NPI 1538606348
  NPD
• Licking Memorial Professional Corp.

  • Surgery Physician
  • Newark, OH
  • NPI 1366461386
  NPD (past)
• Licking Memorial Professional Corp.

  • Pediatrics Physician
  • Utica, OH
  • NPI 1497771521
  NPD (past)
• Adrian Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Adrian, MI
  • NPI 1144611633
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Licking Memorial Hospital

  • General Acute Care Hospital
  • Newark, OH
  • NPI 1568446755

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1517875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1831698729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 W MAIN ST STE 201",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "43055",
            "telephone_number": "220-564-2900",
            "fax_number": "220-564-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 W MAIN ST STE 201",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "43055",
            "telephone_number": "220-564-2900",
            "fax_number": "220-564-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECKARD",
        "first_name": "SADIE",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-06",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sdeckard30212@lickingmemorial.medicity.net",
            "affiliation": "N",
            "address_1": "1717 W Main St Ste 201",
            "city": "Newark",
            "state": "OH",
            "country_code": "US",
            "postal_code": "43055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amanda Leigh Day, APRN
• Jeffrey Paul Dayhuff, DDS
• Marco Mauro De Santis, D.O.
• Loreta Ruth De Zuniga, LMSW
• Anna Faye Deck-Freas
• Maria M Defante, M.D.
• Mark T Defrancisco, DO
• Edward A Del Grosso, M.D.
• Del Opticians, LLC
• Paul Gaston Del Valle, M.D.

• All providers in Newark, OH
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; 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.