Individual provider Active NPI

Sarah M Deuser, PA-C

  • Physician Assistant
  • Moraine, OH
National Provider Identifier
1962674259
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3095 Kettering Blvd
Moraine, OH 45439-1983
Phone
(937) 293-8300
NPI assigned
Mar 27, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2754 OH
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

3095 Kettering Blvd
Moraine, OH 45439-1983

Mailing address

450B Washington Jackson Rd
Suite 105
Eaton, OH 45320-7600
Phone (937) 456-8350

Other identifiers 1

IdentifierTypeStateIssuer
0063173MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20080512000472 OH Practitioner - Physician Assistant 5294814554 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Community Inc.Group PAC ID 7315971066, 20 clinicians

Practice addresses (Care Compare)

3095 Kettering Blvd
Moraine, OH 45439-1983
Phone (937) 293-8300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2754OHMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
South Community Inc. CurrentSince Nov 20, 2023 Accepting new patients
Dayton Behavioral Care, LLC Past Accepting new patients

Locations

3095 Kettering Blvd
Moraine, OH 45439

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1206576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1962674259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450B WASHINGTON JACKSON RD",
            "address_2": "SUITE 105",
            "city": "EATON",
            "state": "OH",
            "postal_code": "453207600",
            "telephone_number": "937-456-8350",
            "fax_number": "937-456-8351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3095 KETTERING BLVD",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391983",
            "telephone_number": "937-293-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEUSER",
        "first_name": "SARAH",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-27",
        "last_updated": "2024-07-09",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "2754",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0063173",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moraine, OH

Sources for this page

Verify at the official NPI Registry.