Noah Dickerson, PT

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

304425 Issued in CA

Practice address

2322 Powell St
Emeryville, CA 94608-1738

Phone

(510) 653-5151

NPI assigned

Aug 28, 2023

Last updated

Aug 28, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 TX, CA2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tuolumne Me-Wuk Indian Health Center IncGroup PAC ID 6507816386, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: noah.dickerson.p1@direct.tmwihc.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tuolumne Mewuk Indian Health Center, Inc

  • Family Medicine Physician
  • Tuolumne, CA
  • NPI 1619952397
  Medicare reassignment Care Compare group NPD
• Yellowhawk Tribal Health Center

  • Clinic/Center
  • Pendleton, OR
  • NPI 1346283488

  TX

  Medicare reassignment NPD
• Tuolumne Me-Wuk Indian Health Center, Inc.

  dba Tuolumne Me-Wuk Health and Wellness Center

  • Family Medicine Physician
  • Sonora, CA
  • NPI 1124286885
  NPD

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

{
    "created_epoch": "1693180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1245015338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "459 23RD ST APT 408",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946122328",
            "telephone_number": "530-215-6424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2322 POWELL ST",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081738",
            "telephone_number": "510-653-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "NOAH",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-28",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "304425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jade Marie-Jaday Dennis
• Deanne Michelle Detmers, M.A.
• Brandon Michael Devlin
• Jaspreet Kaur Dhaliwal, BCBA
• Marissa Diaz
• Priscilla Ding
• Discovery Practice Management, Inc (Center For Discovery, Emeryville)
• Discovery Practice Management, Inc. (Discovery Mood & Anxiety Program, Emeryville)
• Ariane Dobrin
• Elizabeth Wytychak Dods, NP

• Physical Medicine & Rehabilitation Physician in Emeryville, CA
• Providers in Emeryville, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.