Individual provider Active NPI

Debbie Loretta Durisek, M.D.

  • Diagnostic Radiology Physician
  • Ephrata, PA
National Provider Identifier
1881620409
Registry record updated Apr 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD030348E Issued in PA
Practice address
169 Martin Ave
Ephrata, PA 17522-1724
Phone
(717) 859-4454
Fax
(717) 859-4475
NPI assigned
Jun 24, 2006
Last updated
Apr 2, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD030348E PA Primary

Addresses

Primary practice location

169 Martin Ave
Ephrata, PA 17522-1724

Mailing address

169 Martin Ave
Ephrata, PA 17522
Phone (717) 859-4454

Other identifiers 1

IdentifierTypeStateIssuer
0010501410024MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD030348EPAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Schuylkill Health System Medical Group, Inc. Past Accepting new patients
Montgomery Radiology Associates, PC Diagnostic Radiology Past Accepting new patients
Ephrata Radiologic Associates LTD Diagnostic Radiology Past Accepting new patients
Frank Olney & Rudy Nicolas PTRS Diagnostic Radiology PastSince Oct 15, 2008 Accepting new patients
Schuylkill Health System Medical Group, Inc. Past Accepting new patients
Central Pennsylvania MRI Center Diagnostic Radiology Past Accepting new patients

Organizations & group practices 6

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": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238630400000",
    "number": "1881620409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 MARTIN AVE",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "17522",
            "telephone_number": "717-859-4454",
            "fax_number": "717-859-4475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 MARTIN AVE",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175221724",
            "telephone_number": "717-859-4454",
            "fax_number": "717-859-4475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURISEK",
        "first_name": "DEBBIE",
        "middle_name": "LORETTA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-24",
        "last_updated": "2009-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD030348E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010501410024",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ephrata, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.