Active NPI
Matthew Deysher
- Physician Assistant
- Danville, PA
National Provider Identifier
1861969669
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- MA060329
- Practice address
- 100 N Academy Ave
Danville, PA 17822-9800 - Phone
- (570) 271-6211
- NPI assigned
- Oct 30, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 | MA060329 | PA | Primary |
Addresses
Primary practice location
100 N Academy Ave
Danville, PA 17822-9800
Mailing address
13 Eastfield Dr
Lebanon, PA 17042-8000
Phone (717) 673-0352
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA, SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181213002399 | PA | Practitioner - Physician Assistant | 7719222090 | Reassigns benefits to 1 organization |
| I20240122000478 | SC | Practitioner - Physician Assistant | 7719222090 | Reassigns benefits to 3 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Acs Primary Care Physicians - Southeast PC
Practice addresses (Care Compare)
809 82ND Pkwy
Myrtle Beach, SC 29572-4607
Phone (843) 692-1000
Hospital & facility affiliations
- Tidelands Waccamaw Community Hospital
- Tidelands Georgetown Memorial Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA060329 | PA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Georgetown Memorial Hospital | Current | Accepting new patients | |
| Acs Primary Care Physicians - Southeast PC | Physician Assistant | Current | Accepting new patients |
| Geisinger Clinic | Current | Accepting new patients | |
| Geisinger Clinic | Physician Assistant | Current | Accepting new patients |
Locations
100 N Academy Ave
Danville, PA 17822
606 Black River Rd
Georgetown, SC 29440
Phone (843) 527-7000
809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182
Interoperability endpoints
- mdeysher454603@direct.musc.edu
Organizations & group practices 7
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.
-
- Emergency Medicine Physician
- Myrtle Beach, SC
- NPI 1861430555
Physician Assistant, SC
-
- Diagnostic Radiology Physician
- Danville, PA
- NPI 1558313023
-
- Skilled Nursing Facility
- Georgetown, SC
- NPI 1881307056
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540857600000",
"number": "1861969669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13 EASTFIELD DR",
"city": "LEBANON",
"state": "PA",
"postal_code": "170428000",
"telephone_number": "717-673-0352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 N ACADEMY AVE",
"city": "DANVILLE",
"state": "PA",
"postal_code": "178229800",
"telephone_number": "570-271-6211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEYSHER",
"first_name": "MATTHEW",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-10-30",
"last_updated": "2018-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PA",
"license": "MA060329",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Danville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2018; 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.