Individual provider Active NPI

Heather E Okun Demuth, PA-C

  • Physician Assistant
  • Dunmore, PA
National Provider Identifier
1861635336
Registry record updated Aug 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
OA002361 Issued in PA
Practice address
1208 Oneill Hwy
Dunmore, PA 18512-1709
Phone
(570) 207-2612
Fax
(570) 207-2616
NPI assigned
Apr 14, 2009
Last updated
Aug 28, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2013

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 MA053579 PA
Physician Assistant 363A00000X OA002361 PA Primary

Addresses

Primary practice location

1208 Oneill Hwy
Dunmore, PA 18512-1709

Mailing address

201 Harvard Ave
Clarks Green, PA 18411-1115
Phone (570) 430-1779

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
I20090609000057 PA Practitioner - Physician Assistant 5496805715 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA053579PAMDPhysician Assistant
OA002361PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Donna Eget PC Current Accepting new patients
Pma Medical Specialists Past Accepting new patients
Lackawanna Emergency Group PC Physician Assistant Past Accepting new patients
Emergency Services, PC Past Accepting new patients

Locations

1208 Oneill Hwy
Dunmore, PA 18512
Phone (570) 207-2612

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": "1239667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377648000000",
    "number": "1861635336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 HARVARD AVE",
            "city": "CLARKS GREEN",
            "state": "PA",
            "postal_code": "184111115",
            "telephone_number": "570-430-1779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 ONEILL HWY",
            "city": "DUNMORE",
            "state": "PA",
            "postal_code": "185121709",
            "telephone_number": "570-207-2612",
            "fax_number": "570-207-2616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKUN DEMUTH",
        "first_name": "HEATHER",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-14",
        "last_updated": "2013-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA053579",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA002361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunmore, PA

Sources for this page

Verify at the official NPI Registry.