NPIMap

Individual provider Active NPI

James Daniel Dewar, D.O.

  • Interventional Cardiology Physician
  • Peoria, IL
National Provider Identifier
1013128222
Registry record updated Aug 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
56304 Issued in MN
Practice address
530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone
(309) 655-7257
NPI assigned
May 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125-049248 IL
Interventional Cardiology Physician 207RI0011X 56304 MN Primary

Addresses

Primary practice location

530 NE Glen Oak Ave
Peoria, IL 61637-0001

Mailing address

103 Woodbrook CT
East Peoria, IL 61611-4779
Phone (309) 922-1006

Other identifiers 4

IdentifierTypeStateIssuer
036120002MedicaidIL
CA4079OtherILRR MEDICARE GROUP PTAN
P00617111OtherILRR MEDICARE GROUP MEMBER PTAN
809840OtherILMEDICARE GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130820000154 MN Practitioner - Interventional CardiologyPractitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 1355412917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Health of Northern MinnesotaGroup PAC ID 5597725168, 349 clinicians

Practice addresses (Care Compare)

1300 Anne St NW
Bemidji, MN 56601-5103
Phone (218) 333-5000

1611 Anne St NW
Bemidji, MN 56601-5114
Phone (218) 333-5000

Hospital & facility affiliations

  • Sanford Bemidji Medical Center Hospital, Bemidji, MN, CCN 240100
  • Rainy Lake Medical Center Hospital, International Falls, MN, CCN 241322
  • Sanford Bagley Medical Center Hospital, Bagley, MN, CCN 241328
  • St Josephs Area Health Services Hospital, Park Rapids, MN, CCN 241380
  • Sanford Medical Center Fargo Hospital, Fargo, ND, CCN 350011

Merit-based Incentive Payment System (MIPS)

Final score
86.56 of 100Reported as group
Quality
74.25
Promoting interoperability
100
Improvement activities
40
Cost
76.16

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting81
Pacemaker insertion or repair18
Leg revascularization (restoring blood flow)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
125-049248ILMDInternal Medicine Physician
56304MNMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Health of Northern Minnesota Current Accepting new patients
Sanford Health of Northern Minnesota CurrentSince Jul 15, 2013 Accepting new patients
Sanford Health of Northern Minnesota Internal Medicine CurrentSince Jul 15, 2013 Accepting new patients

Locations

1611 Anne St NW
Bemidji, MN 56601
Phone (218) 333-2020

1300 Anne St NW
Bemidji, MN 56601
Phone (218) 333-5794

4000 28th Ave S
Moorhead, MN 56560
Phone (701) 234-3200

1720 US Highway 59 SE
Thief Rvr Fls, MN 56701
Phone (218) 681-4747

3001 Sanford Pkwy
Thief Rvr Fls, MN 56701
Phone (218) 681-4240

Organizations & group practices 3

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1180310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377734400000",
    "number": "1013128222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 WOODBROOK CT",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616114779",
            "telephone_number": "309-922-1006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616370001",
            "telephone_number": "309-655-7257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWAR",
        "first_name": "JAMES",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-28",
        "last_updated": "2013-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125-049248",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MN",
            "license": "56304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036120002",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP PTAN",
            "identifier": "CA4079",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP MEMBER PTAN",
            "identifier": "P00617111",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "809840",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.