Individual provider Active NPI

Deborah Sharp-Dale, PA

  • Physician Assistant
  • Whittier, CA
National Provider Identifier
1194767756
Registry record updated Oct 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA13769 Issued in CA
Practice address
12401 Washington Blvd
Whittier, CA 90602-1006
Phone
(562) 698-0811
Fax
(818) 587-2493
NPI assigned
Jun 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA13769 CA Primary

Addresses

Primary practice location

12401 Washington Blvd
Whittier, CA 90602-1006

Mailing address

PO Box 4419
Woodland Hills, CA 91365-4419
Phone (800) 506-6895

Other identifiers 2

IdentifierTypeStateIssuer
PA13769MedicaidCA
P00218362OtherCARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090107000315 NC Practitioner - Physician Assistant 6507844107 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Duke Health Integrated Practice IncGroup PAC ID 8325412737, 3,140 clinicians

Practice addresses (Care Compare)

234 Crooked Creek Pkwy
Durham, NC 27713-8505
Phone (919) 684-8111

40 Duke Medicine Cir
Durham, NC 27710-4000
Phone (919) 684-8111

Hospital & facility affiliations

  • Duke University Hospital Hospital, Durham, NC, CCN 340030

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Duke University Affiliated Physicians, Inc. CurrentSince Jul 1, 2021 Accepting new patients
Duke Health Integrated Practice, Inc. CurrentSince Jul 1, 2023 Accepting new patients
Duke Health Integrated Practice, Inc. CurrentSince Jul 1, 2023 Accepting new patients
Duke University Affiliated Physicians, Inc. CurrentSince Jul 1, 2021 Accepting new patients

Locations

5213 S Alston Ave
Durham, NC 27713
Phone (919) 620-4700

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588

2100 Erwin Rd
Durham, NC 27705
Phone (919) 648-8111

1901 Hillandale Rd
Ste D
Durham, NC 27705
Phone (919) 383-4355

Interoperability endpoints

  • Direct secure messaging: dsharpdale3942@direct.medicine.duke.edu

Organizations & group practices 5

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 6

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": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223942400000",
    "number": "1194767756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4419",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913654419",
            "telephone_number": "800-506-6895",
            "fax_number": "818-587-2493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12401 WASHINGTON BLVD",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906021006",
            "telephone_number": "562-698-0811",
            "fax_number": "818-587-2493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARP-DALE",
        "first_name": "DEBORAH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-11",
        "last_updated": "2008-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA13769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA13769",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00218362",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Whittier, CA

Sources for this page

Verify at the official NPI Registry.