Daniel Raleigh Dewar, D.C.
Individual provider Active NPI Chiropractor · Portage, IN
NPI 1063512937 · NPPES record last updated Jun 24, 2020
Key facts
- NPI
- 1063512937
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 08001702A (IN)
- Practice address
- 6050 Sterling Creek Rd
Portage, IN 46368-7752 - Phone
- (219) 763-8112
- Fax
- (219) 763-7245
- NPI assigned
- Sep 22, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 23
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Northshore Health Centers Inc
Practice addresses (Care Compare)
6050 Sterling Creek Rd
Portage, IN 46368-7752
Phone 21976381123233
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050115000031 | IN | Practitioner - Chiropractic | 3779532890 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northshore Health Centers Inc | Current | Accepting new patients | |
| Northshore Health Centers, Inc. | Current |
Accepting new patients | |
| Northshore Health Centers, Inc. | Chiropractor | Current |
Accepting new patients |
| Northshore Health Centers, Inc. | Past | Accepting new patients |
Locations
6050 Sterling Creek Rd
Portage, IN 46368
Phone (219) 212-0188
6450 US Highway 6
Portage, IN 46368
Phone (219) 764-6104
Interoperability endpoints
- dan.dewar.p1@direct.northshorehealth.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 08001702A | IN | Yes |
Addresses
Primary practice location
6050 Sterling Creek Rd
Portage, IN 46368-7752
Mailing address
PO Box 1430
Portage, IN 46368-9230
Phone (219) 763-8112
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200138490 | Medicaid | IN |
Other providers in Portage, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.