Individual provider Active NPI

Allie Therese Thornburg, PA-C

  • Physician Assistant
  • Dubuque, IA
National Provider Identifier
1235766734
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
101969 Issued in IA
Practice address
1500 Associates Dr
Dubuque, IA 52002-2201
Phone
(563) 584-4370
Fax
(563) 584-4232
NPI assigned
Mar 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 101969 IA
Physician Assistant 363A00000X 101969 IA Primary

Addresses

Primary practice location

1500 Associates Dr
Dubuque, IA 52002-2201

Mailing address

1500 Associates Dr
Dubuque, IA 52002-2201
Phone (563) 584-4370

Other names 1

  • Allie Therese Funke Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20220321000700 IA Practitioner - Physician Assistant 1951796465 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Associates Clinic P CGroup PAC ID 3870491228, 228 clinicians

Practice addresses (Care Compare)

1000 Langworthy St
Dubuque, IA 52001-7313
Phone (563) 584-4100

1500 Associates Dr
Dubuque, IA 52002-2201
Phone (563) 584-4100

Hospital & facility affiliations

  • Mercyone Dubuque Medical Center Hospital, Dubuque, IA, CCN 160069
  • Jackson County Regional Health Center Hospital, Maquoketa, IA, CCN 161329

Merit-based Incentive Payment System (MIPS)

Final score
80.02 of 100Reported as group
Quality
75.68
Promoting interoperability
78
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
101969IAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates Clinic P C CurrentSince Dec 9, 2024 Accepting new patients

Locations

1500 Associates Dr
Dubuque, IA 52002
Phone (563) 584-4100

1000 Langworthy St
Dubuque, IA 52001
Phone (563) 584-3455

Interoperability endpoints

  • Direct secure messaging: athornburg77158@uihcdirect.org
  • Direct secure messaging: athornburg3925829@direct.trinity-health.org

Organizations & group practices 1

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": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1235766734",
    "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": "563-584-4370",
            "fax_number": "563-584-4232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 ASSOCIATES DR",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520022201",
            "telephone_number": "563-584-4370",
            "fax_number": "563-584-4232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNBURG",
        "first_name": "ALLIE",
        "middle_name": "THERESE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-25",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IA",
            "license": "101969",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "101969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALLIE",
            "last_name": "FUNKE",
            "middle_name": "THERESE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dubuque, IA

Sources for this page

Verify at the official NPI Registry.