Active NPI
Clare De Pue, PA-C
- Physician Assistant
- Marquette, MI
National Provider Identifier
1871603449
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601001211
- Practice address
- 1414 W Fair Ave
Ste 134
Marquette, MI 49855-2675 - Phone
- (906) 226-2233
- Fax
- (906) 226-2409
- NPI assigned
- Aug 30, 2006
- Last updated
- Mar 7, 2023
- 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 | 5601001211 | MI | Primary |
Addresses
Primary practice location
1414 W Fair Ave
Ste 134
Marquette, MI 49855-2675
Mailing address
1414 W Fair Ave
Suite 134
Marquette, MI 49855-2675
Phone (906) 226-2233
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5601001211 | Other | MI | MI STATE MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1871603449",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1414 W FAIR AVE",
"address_2": "SUITE 134",
"city": "MARQUETTE",
"state": "MI",
"postal_code": "498552675",
"telephone_number": "906-226-2233",
"fax_number": "906-226-2409"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1414 W FAIR AVE",
"address_2": "STE 134",
"city": "MARQUETTE",
"state": "MI",
"postal_code": "498552675",
"telephone_number": "906-226-2233",
"fax_number": "906-226-2409"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE PUE",
"first_name": "CLARE",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601001211",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MI STATE MEDICAL LICENSE",
"identifier": "5601001211",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marquette, MI
- Alycia Davidson, FNP-C
- Davis Drug Co (campus pharmacy)
- Alicia Davis, MS, LLPC
- Steven Michael Davis, D.D.S.
- Daniel Domingues De Oliveira, M.D.
- Debra L. Smith, Psy.D., PLLC (Superior Psychological Services)
- Megan Marie Dechambeau, MS, AT, ATC
- Alyssa Marie Decremer
- Susan Marie Degroot, MSW
- Christopher Allen Dehlin, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.