Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

MR. GEORGE JOSEPH DEVITA PA-C
NPI 1104803964
Physician Assistant - Medical in Fort Drum, NY

Q: What is the provider's specialty?

The provider's specialty is Physician Assistant with taxonomy code 363AM0700X and a focus in Medical.

Active since December 22, 2005PECOS Enrolled

11050 MOUNT BELVEDERE BLVD, USA MEDDAC ATTN: CREDENTIALS, FORT DRUM, NY 13602(315) 772-4025(315) 772-9498 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Mr. George Joseph Devita Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. GEORGE JOSEPH DEVITA PA-C (NPI 1104803964) is an individual medical provider in Fort Drum, New York and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS and is a graduate of University Of Nebraska College Of Medicine (2000).

NPPES Registry Identity

NPI1104803964

Entity TypeIndividualMale

Primary Taxonomy363AM0700X

Provider Legal NameMR. GEORGE JOSEPH DEVITACredential: PA-C

Location Address11050 MOUNT BELVEDERE BLVD, USA MEDDAC ATTN: CREDENTIALSFort Drum, NY 13602-5438

Mailing Address27082 Waddingham RdEvans Mills, NY 13637-3277 · (315) 772-3225

Phone(315) 772-4025

Fax(315) 772-9498

Sole ProprietorNo

Medical School CMSUniversity Of Nebraska College Of MedicineGraduated 2000

Enumeration DateDecember 22, 2005

Last NPPES UpdateJuly 13, 2026

✔ NPI 1104803964 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

11050 MOUNT BELVEDERE BLVD, Fort Drum, NY 13602

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. George Joseph Devita Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8123201993

PECOS Enrollment IDI20110331000924

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.