Individual provider Active NPI

Brian Dwyer, PA-C

  • Physician Assistant
  • Chico, CA
National Provider Identifier
1194445478
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
65081 Issued in CA
Practice address
1531 Esplanade
Chico, CA 95926-3310
Phone
(530) 332-7047
NPI assigned
Aug 29, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 65081 CA Primary

Addresses

Primary practice location

1531 Esplanade
Chico, CA 95926-3310

Mailing address

1531 Esplanade
Chico, CA 95926-3310
Phone (530) 332-7047

Other practice location 1

2730 S Moody Ave
Portland, OR 97201-5042
Phone (925) 918-5829

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20241024002171 CA Practitioner - Physician Assistant 8527591890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Oregon Health Sciences University School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Enloe Medical CenterGroup PAC ID 9739092388, 330 clinicians

Practice addresses (Care Compare)

1531 Esplanade
Chico, CA 95926-3310
Phone (530) 332-7300

1600 Esplanade
Suite C
Chico, CA 95926-3369
Phone (530) 332-4470

Hospital & facility affiliations

  • Enloe Health Hospital, Chico, CA, CCN 050039
  • Oroville Hospital Hospital, Oroville, CA, CCN 050030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
65081CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Enloe Medical Center CurrentSince Oct 1, 2024 Accepting new patients
Enloe Medical Center CurrentSince Oct 1, 2024 Accepting new patients
Enloe Medical Center Past Accepting new patients

Locations

1390 E Lassen Ave
Chico, CA 95973
Phone (530) 332-6332

1600 Esplanade
Ste C
Chico, CA 95926
Phone (530) 332-4470

Interoperability endpoints

  • Direct secure messaging: bdwyer74320@enloedirect.org

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 2

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": "1661731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1194445478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1531 ESPLANADE",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959263310",
            "telephone_number": "530-332-7047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1531 ESPLANADE",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959263310",
            "telephone_number": "530-332-7047"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2730 S Moody Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972015042",
            "country_code": "US",
            "telephone_number": "925-918-5829",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DWYER",
        "first_name": "BRIAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-29",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "65081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chico, CA

Sources for this page

Verify at the official NPI Registry.