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DUSTIN DERSTINE PAC
NPI 1245056076
Physician Assistant in Lehighton, PA

Active since November 26, 2024PECOS EnrolledAccepts Medicare Assignment
575 S 9TH ST STE 7, LEHIGHTON, PA 18235(570) 645-1000 Get Directions Write a Review

NPPES record last updated: November 26, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dustin Derstine Pac NPPES

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

DUSTIN DERSTINE PAC (NPI 1245056076) is an individual physician assistant in Lehighton, Pennsylvania, licensed in Pennsylvania (MA066084) and active in the NPI registry since November 2024. He is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1245056076
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameDUSTIN DERSTINECredential: PAC
Location Address575 S 9TH ST STE 7Lehighton, PA 18235-2517
Mailing Address575 S 9th St Ste 7Lehighton, PA 18235-2517 · (570) 645-1000
Phone(570) 645-1000
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateNovember 26, 2024
NPPES CertifiedNovember 26, 2024
✔ NPI 1245056076 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in PA · MA066084
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
575 S 9TH ST STE 7, Lehighton, PA 18235
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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

Dustin Derstine Pac 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 ID6709315807
PECOS Enrollment IDI20250117001410
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 18235 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.88 typical visit price
range $54.64 – $166.87
Typical copayment $21.22 (range $13.66 – $41.71)
Most-billed visit code 99203
Established Patient
$68.36 typical visit price
range $17.33 – $135.84
Typical copayment $17.09 (range $4.33 – $33.96)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHANNON DEREAMUS CRNP
Nurse Practitioner
575 S 9TH ST STE 7
LEHIGHTON, PA 18235
Carbon County (570) 645-1000
MRS. BARBARA E KOCHER C.R.N.P
Nurse Practitioner
575 S 9TH ST STE 7
LEHIGHTON, PA 18235
Carbon County (570) 645-1000
THE CARBON SCHUYLKILL COMMUNITY HOSPITAL, INC.
Clinic/Center (Urgent Care)
575 S 9TH ST STE 7
LEHIGHTON, PA 18235
Carbon County (570) 645-1000
KELSEY ANN SIEGFRIED CRNP
Nurse Practitioner
575 S 9TH ST STE 7
LEHIGHTON, PA 18235
Carbon County (570) 645-1000
LINDSAY DANIELLE BALITZA
Nurse Practitioner
575 S 9TH ST STE 7
LEHIGHTON, PA 18235
Carbon County (570) 645-1000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dustin Derstine's NPI number?

The NPI number for Dustin Derstine is 1245056076. It was assigned to this individual provider in the NPPES registry on November 26, 2024.

Where is Dustin Derstine located?

Dustin Derstine practices at 575 S 9th St Ste 7, Lehighton, PA 18235. The listed phone number is (570) 645-1000.

What is Dustin Derstine's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Dustin Derstine enrolled in Medicare?

Yes. Dustin Derstine is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Dustin Derstine was last updated on November 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.