Individual provider Active NPI

Robert Dejesus, M.D.

  • Gastroenterology Physician
  • Greensburg, PA
National Provider Identifier
1962515544
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD015344E Issued in PA
Practice address
545 Rugh St
Greensburg, PA 15601-5636
Phone
(724) 836-5500
Fax
(724) 836-8471
NPI assigned
Aug 16, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 4

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.

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: Yes
Green means eligible to order or refer.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20060209000170 PA Practitioner - Gastroenterology 1052326261 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Excela Health Physician Practices, Inc Current Accepting new patients
Excela Health Physician Practices, Inc. CurrentSince Jul 1, 2012 Accepting new patients
Excela Health Physician Practices, Inc. CurrentSince Jul 1, 2012 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

532 W Pittsburgh St
Greensburg, PA 15601
Phone (724) 832-4000

905 Spruce St
Ste 201
North Huntingdon, PA 15642
Phone (724) 864-1115

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD015344E PA Primary

Addresses

NPPES NPI Registry

Primary practice location

545 Rugh St
Greensburg, PA 15601-5636

Mailing address

545 Rugh St
Greensburg, PA 15601-5636
Phone (724) 836-5500

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
0005960090001MedicaidPA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962515544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 RUGH ST",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156015636",
            "telephone_number": "724-836-5500",
            "fax_number": "724-836-8471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 RUGH ST",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156015636",
            "telephone_number": "724-836-5500",
            "fax_number": "724-836-8471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJESUS",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PA",
            "license": "MD015344E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005960090001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensburg, PA

Sources for this page

Verify at the official NPI Registry.