Individual provider Active NPI

Haley Hani Dickow

  • Physician Assistant
  • Cleveland, OH
National Provider Identifier
1245758739
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5334 Issued in SC
Practice address
2500 Metrohealth Dr
Cleveland, OH 44109-1900
Phone
(216) 477-0017
NPI assigned
Sep 5, 2017
Last updated
Aug 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5334 SC Primary
Medical Physician Assistant 363AM0700X 5601008291 MI

Addresses

Primary practice location

2500 Metrohealth Dr
Cleveland, OH 44109-1900

Mailing address

PO Box 23321
New York, NY 10087-4321

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@directmusc.edu Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, SC, OH3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20230630002761 MI Practitioner - Physician Assistant 9234598764 Reassigns benefits to 1 organization
I20241007000242 SC Practitioner - Physician Assistant 9234598764 Reassigns benefits to 1 organization
I20241010003010 OH Practitioner - Physician Assistant 9234598764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Wayne State University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Musc Community PhysiciansGroup PAC ID 6507260668, 1,353 clinicians
The Metrohealth SystemGroup PAC ID 8628982949, 1,150 clinicians

Practice addresses (Care Compare)

169 Ashley Ave
Charleston, SC 29425-8905

2500 Metrohealth Dr
Cleveland, OH 44109-1900
Phone (216) 778-7800

2500 Metrohealth Dr
Cleveland, OH 44109-1998

506 N St
Bamberg, SC 29003-1319
Phone (803) 245-6290

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2978NEMDPhysical Therapist
5334SCMDPhysician Assistant
5601008291MIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Musc Community Physicians CurrentSince Sep 1, 2024 Accepting new patients
The Metrohealth System Current Accepting new patients
Musc Community Physicians CurrentSince Sep 1, 2024 Accepting new patients
The Metrohealth System CurrentSince Apr 4, 2024 Accepting new patients
Regional Medical Center of Orangeburg and Calhoun Counties Past Accepting new patients
Muc-Papillion LLC Past Accepting new patients

Locations

2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

Interoperability endpoints

  • Direct secure messaging: hdickow274913@direct.metrohealth.org

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1504569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1245758739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23321",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100874321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 METROHEALTH DR",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441091900",
            "telephone_number": "216-477-0017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKOW",
        "first_name": "HALEY",
        "middle_name": "HANI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-05",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "5334",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601008291",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@directmusc.edu",
            "affiliation": "N",
            "endpointDescription": "SKIP",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "SKIP",
            "address_1": "PO Box 23321",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100874321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.