Todd Bryan Dykstra, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-12474 Issued in NC

Practice address

2604 Dr Martin Luther King Jr Blvd
New Bern, NC 28562-4238

Phone

(252) 638-4023

Fax

(252) 633-2833

NPI assigned

May 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

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

Albany Medical College of Union University, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carolinaeast PhysiciansGroup PAC ID 0143378117, 203 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Pollocksville, NC, CCN 347333
• Pruitthealth Home Health New Bern Home health agency, New Bern, NC, CCN 347026
• Carolina East Medical Center Hospital, New Bern, NC, CCN 340131

Merit-based Incentive Payment System (MIPS)

Final score

72.61 of 100Reported as group

Quality

57.39

Promoting interoperability

68

Improvement activities

40

Cost

77.97

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tdykstra19522@carolinaeastmc.direct-ci.com

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.

• Carolinaeast Physicians

  • Cardiovascular Disease Physician
  • New Bern, NC
  • NPI 1104066794
  Medicare reassignment Care Compare group
• Carolinaeast Physicians

  • Pediatrics Physician
  • New Bern, NC
  • NPI 1235430976
  NPD
• Carolinaeast Physicians

  • Obstetrics & Gynecology Physician
  • New Bern, NC
  • NPI 1619868981
  NPD
• Carolinaeast Physicians

  • Internal Medicine Physician
  • Pollocksville, NC
  • NPI 1255632006
  NPD (past)
• Community Care Physicians, PLLC

  • Family Medicine Physician
  • Ballston Spa, NY
  • NPI 1548541246
  NPD (past)
• Southeast Iowa Regional Medical Center, Inc.

  • General Practice Physician
  • West Burlington, IA
  • NPI 1164433884
  NPD (past)

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

• Carolinaeast Medical Center

  • General Acute Care Hospital
  • New Bern, NC
  • NPI 1801852835
  Care Compare affiliation
• Pruitthealth Home Health, Inc.

  • Home Health Agency
  • New Bern, NC
  • NPI 1891197380
  Care Compare affiliation
• Tar Heel Health Care Services, LLC

  • Home Health Agency
  • Pollocksville, NC
  • NPI 1043243835
  Care Compare affiliation

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1154373983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 68",
            "city": "POLLOCKSVILLE",
            "state": "NC",
            "postal_code": "285730068",
            "telephone_number": "252-638-4023",
            "fax_number": "252-633-2833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2604 DR MARTIN LUTHER KING JR BLVD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285624238",
            "telephone_number": "252-638-4023",
            "fax_number": "252-633-2833"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3757 Carman Rd",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Schenectady",
            "state": "NY",
            "postal_code": "123035438",
            "country_code": "US",
            "telephone_number": "518-355-7063",
            "fax_number": "518-357-0646",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DYKSTRA",
        "first_name": "TODD",
        "middle_name": "BRYAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "009787-1",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IA",
            "license": "001382",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-12474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02970441",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "101220000005",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Renee Durden, M.A., CCC-SLP
• Lynn E Durham, LCSW
• Yashia Durham, MA, MSW, LCSWA
• April Dawn Durning, FNP
• Dustin Alan Dvoracek
• Danielle Dyson
• Jennifer S Dziwanowski, NP
• Adrienne Pak Earle, O.D.
• Marcus Earle, D.O.
• Latoya Eason

• Physician Assistant in New Bern, NC
• Providers in New Bern, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; 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.