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ISAAC DEATHERAGE DO, MPH
NPI 1942998810
General Practice in Spring Lake, MI

Active since April 27, 2023PECOS EnrolledAccepts Medicare Assignment
18627 144TH AVE, SPRING LAKE, MI 49456(918) 814-6422 Get Directions Write a Review

NPPES record last updated: April 9, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Isaac Deatherage Do, Mph NPPES

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

ISAAC DEATHERAGE DO, MPH (NPI 1942998810) is an individual general practice provider in Spring Lake, Michigan, licensed in Michigan (5101028511) and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS and is a graduate of Pacific Nw Un Of Hs, Col Of Osteopathic Medicine (2022).

NPPES Registry Identity

NPI1942998810
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameISAAC DEATHERAGECredential: DO, MPH
Location Address18627 144TH AVESpring Lake, MI 49456-9520
Mailing Address18627 144th AveSpring Lake, MI 49456-9520 · (918) 814-6422
Phone(918) 814-6422
Sole ProprietorYes
Medical School CMSPacific Nw Un Of Hs, Col Of Osteopathic MedicineGraduated 2022
Enumeration DateApril 27, 2023
Last NPPES UpdateApril 9, 2025
NPPES CertifiedApril 9, 2025
✔ NPI 1942998810 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in MI · 5101028511
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
18627 144TH AVE, Spring Lake, MI 49456
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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

Isaac Deatherage Do, Mph 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 ID8921501586
PECOS Enrollment IDI20250911000150
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.

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 Isaac Deatherage's NPI number?

The NPI number for Isaac Deatherage is 1942998810. It was assigned to this individual provider in the NPPES registry on April 27, 2023.

Where is Isaac Deatherage located?

Isaac Deatherage practices at 18627 144th Ave, Spring Lake, MI 49456. The listed phone number is (918) 814-6422.

What is Isaac Deatherage's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Isaac Deatherage enrolled in Medicare?

Yes. Isaac Deatherage 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 Isaac Deatherage was last updated on April 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.