Marc E Dicklin, P.A. -C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

001351 Issued in IA

Practice address

1000 Langworthy St
Dubuque, IA 52001-7313

Phone

(563) 584-3455

Fax

(563) 584-3314

NPI assigned

Aug 10, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WY

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

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Summit Memorial Medical Group LLCGroup PAC ID 1254876683, 40 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Summit Memorial Medical Group LLC

  • General Practice Physician
  • Casper, WY
  • NPI 1598469462
  Medicare reassignment Care Compare group NPD
• St Mary Medical Center

  • Family Medicine Physician
  • Galesburg, IL
  • NPI 1457308710

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422230400000",
    "number": "1205837408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 ASSOCIATES DR",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520022201",
            "telephone_number": "563-584-4100",
            "fax_number": "563-584-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 LANGWORTHY ST",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520017313",
            "telephone_number": "563-584-3455",
            "fax_number": "563-584-3314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKLIN",
        "first_name": "MARC",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "P.A. -C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2015-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "001351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Demmer, CRNA
• Krista Dewar, FNP-C
• Andrew M Dewitt, DDS
• Anna Marie Dewitt, ARNP
• Ellen E Dickey, SLP
• Melissa Benedetto Digmann, LISW
• Kayci Dimmer
• Kathryn May Diraimondo
• Discover Lab Services LLC
• DME Supplies Inc

• Physician Assistant in Dubuque, IA
• Providers in Dubuque, IA by specialty
• Physician Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2015; 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.