Organization Active NPI

Premier PA Consulting, LLC

  • Surgical Physician Assistant
  • Charleston, SC
National Provider Identifier
1083595730
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Legal business name
PREMIER PA CONSULTING, LLC
Practice address
501 Salt Wedge Dr Unit 5301
Charleston, SC 29492-9025
Phone
(347) 964-3084
NPI assigned
Sep 9, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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

Authorized official

Name
Timothy Steffen Dahl, PA-CNPI 1518567601
Title
Physician Assistant
Phone
(347) 964-3084

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X Primary

Addresses

Primary practice location

501 Salt Wedge Dr Unit 5301
Charleston, SC 29492-9025

Mailing address

501 Salt Wedge Dr Unit 5301
Charleston, SC 29492-9025

Other practice location 1

50 Wason Ave Fl 2
Springfield, MA 01107-1280
Phone (413) 794-1800

Other practice location 2

759 Chestnut St
Springfield, MA 01199-0001
Phone (413) 794-0000

Other practice location 3

759 Chestnut St
Springfield, MA 01199-1001
Phone (413) 794-0000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251029002027 MA Part B Supplier - Clinic/Group Practice 5395234462 Receives reassigned benefits from 1 practitioner
Practice locations: Springfield, MA

National Provider Directory

National Provider Directory

Locations

759 Chestnut St
#2
Springfield, MA 01199

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1757376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763337600000",
    "number": "1083595730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 SALT WEDGE DR UNIT 5301",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294929025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 SALT WEDGE DR UNIT 5301",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294929025",
            "telephone_number": "347-964-3084"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Wason Ave Fl 2",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MA",
            "postal_code": "011071280",
            "country_code": "US",
            "telephone_number": "413-794-1800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "759 Chestnut St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MA",
            "postal_code": "011990001",
            "country_code": "US",
            "telephone_number": "413-794-0000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "759 Chestnut St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MA",
            "postal_code": "011991001",
            "country_code": "US",
            "telephone_number": "413-794-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PREMIER PA CONSULTING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-09",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A",
        "authorized_official_last_name": "DAHL",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "STEFFEN",
        "authorized_official_title_or_position": "PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "347-964-3084",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.