Peter Cummins Dyke II, M.D.

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

2010021890 Issued in MO

Practice address

500 N Keene St
Suite 207
Columbia, MO 65201-8370

Phone

(573) 219-3960

Fax

(573) 219-3964

NPI assigned

Mar 7, 2007

Last updated

Jan 24, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pediatric Medicine

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1326336058
  Medicare reassignment Care Compare group NPD
• St Lukes Clinic-Treasure Valley LLC

  dba St Lukes RHC - Trinity Mountain

  • Family Medicine Physician
  • Mountain Home, ID
  • NPI 1417297821
  NPD
• Marshfield Clinic Inc

  dba Marshfield Clinic Florida Teleradiology/Telehealth

  • Clinic/Center
  • Marshfield, WI
  • NPI 1952347981
  NPD (past)
• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  NPD (past)

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1346371143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7687",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652057687",
            "telephone_number": "573-882-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N KEENE ST",
            "address_2": "SUITE 207",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018370",
            "telephone_number": "573-219-3960",
            "fax_number": "573-219-3964"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "520 S Eagle Rd Ste 2204",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836426351",
            "country_code": "US",
            "telephone_number": "208-336-9188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DYKE",
        "first_name": "PETER",
        "middle_name": "CUMMINS",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "ID",
            "license": "M-16980",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "WI",
            "license": "50124-020",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MO",
            "license": "2010021890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MUDOCREFERRAL@direct.health.missouri.edu",
            "affiliation": "Y",
            "endpointDescription": "Endpoint is used to receive electronic continuity of care documents (C-CDA) for outpatient referrals.",
            "affiliationName": "Curators of the University of Missouri",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "DIRECT",
            "address_1": "1 Hospital Dr",
            "city": "Columbia",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652120001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Robert H Dye, D.D.S.
• Dye/Harl, LLC
• Carla Alexander Dyer, M.D.
• Jonathan A Dyer, M.D.
• Kristin Dyer
• Dynamic Lifeskills Inc
• Christopher B Dysart, C.R.N.A.
• Eric Allen Eades, RN
• Tyler Thomas Eads
• Linda B Eagle, OTRL

• Pediatric Cardiology Physician in Columbia, MO
• Providers in Columbia, MO by specialty
• Pediatric Cardiology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; 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.