Dori Lyn Wasmundt, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA03407 Issued in TX

Practice address

125 W Park Ave
Hereford, TX 79045-4201

Phone

(806) 364-7688

Fax

(806) 364-7694

NPI assigned

Jul 29, 2005

Last updated

Apr 1, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Regence Health Network IncGroup PAC ID 5698682557, 24 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hereford Regional Medical Center Hospital, Hereford, TX, CCN 450155
• Bsa Hospital Hospital, Amarillo, TX, CCN 450231

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dori.wasmundt.1@12120.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Regence Health Network Inc

  • Federally Qualified Health Center (FQHC)
  • Plainview, TX
  • NPI 1083613640
  Medicare reassignment Care Compare group
• Regence Health Network Inc

  • Federally Qualified Health Center (FQHC)
  • Amarillo, TX
  • NPI 1003813056
  NPD

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

• Bsa Hospital LLC

  • General Acute Care Hospital
  • Amarillo, TX
  • NPI 1407191984
  Care Compare affiliation
• Deaf Smith County Hospital District

  dba Hereford Regional Medical Center

  • General Acute Care Hospital
  • Hereford, TX
  • NPI 1568454403
  Care Compare affiliation

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585699200000",
    "number": "1033119169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 W 8TH ST",
            "city": "PLAINVIEW",
            "state": "TX",
            "postal_code": "790726737",
            "telephone_number": "806-293-8561",
            "fax_number": "806-293-8413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 W PARK AVE",
            "city": "HEREFORD",
            "state": "TX",
            "postal_code": "790454201",
            "telephone_number": "806-364-7688",
            "fax_number": "806-364-7694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASMUNDT",
        "first_name": "DORI",
        "middle_name": "LYN",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-29",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "191407901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Hereford, TX
• Providers in Hereford, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.