Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Matthew Robert Dettra, PA-C

Individual provider Medical Physician Assistant · NPI 1760041636

Matthew Robert Dettra, PA-C is a Physician Assistant in Fort Washington, Pennsylvania. Qualified in 2019, 7 years ago. Practices with Dermatology and Cosmetic Surgery Institute PC, a 4-clinician group, works from 2 locations and accepts Medicare assignment.

Years since qualifying
7
In the registry since
2019
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

455 Pennsylvania Ave Ste 127
Fort Washington, PA 19034-3409
Phone: (215) 793-9755
Fax: (215) 412-3587
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1240 S Broad St Ste 200, Lansdale, PA 19446-5395 — (215) 361-3376

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X

Record details

NPI number1760041636
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 13, 2019
Last updated in NPPESMay 25, 2023
Certification dateMay 24, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Dermatology And Cosmetic Surgery Institute Pc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Fort Washington