Individual provider Active NPI

David A Dwyer, M.D.

  • Emergency Medicine Physician
  • Bloomington, IN
National Provider Identifier
1376553339
Registry record updated Apr 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
36271 Issued in KY
Practice address
601 W 2ND St
Bloomington, IN 47403-2317
Phone
(812) 353-9515
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01069190A IN
Emergency Medicine Physician 207P00000X 36271 KY Primary

Addresses

Primary practice location

601 W 2ND St
Bloomington, IN 47403-2317

Mailing address

601 W 2ND St
Bloomington, IN 47403-2317
Phone (812) 353-9515

Other practice location 1

811 E Parrish Ave
Owensboro, KY 42303-3258
Phone (270) 685-0216

Other identifiers 1

IdentifierTypeStateIssuer
64019482MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20121204000024 IN Practitioner - Emergency Medicine 7315851862 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Sanford School of Medicine of University of South Dakota, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians
Indiana University Health Southern Indiana Physicians LLCGroup PAC ID 6204748197, 474 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

601 W 2ND St
Indiana University So in Phy Inc
Bloomington, IN 47403-2317
Phone (888) 484-3258

Hospital & facility affiliations

  • Indiana University Health Bloomington Hospital Hospital, Bloomington, IN, CCN 150051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36271KYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Professionals of Indiana, P.C. Emergency Medicine CurrentSince May 5, 2020 Accepting new patients
Indiana University Health Southern Indiana Physicians, LLC Emergency Medicine CurrentSince Jun 21, 2020 Accepting new patients
Indiana University Health Southern Indiana Physicians LLC CurrentSince Jun 21, 2020 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Jan 1, 2026 Accepting new patients
Emergency Physicians Group PSC Emergency Medicine Past Accepting new patients

Locations

2015 Jackson St
Anderson, IN 46016
Phone (765) 646-8243

601 W 2nd St
Bloomington, IN 47403
Phone (812) 353-5252

727 W 2nd St
Bloomington, IN 47403
Phone (812) 353-3450

3700 Washington Ave
Evansville, IN 47714
Phone (812) 232-0021

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

1701 S Creasy Ln
Lafayette, IN 47905
Phone (765) 502-4400

Organizations & group practices 5

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 1

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586736000000",
    "number": "1376553339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 W 2ND ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032317",
            "telephone_number": "812-353-9515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W 2ND ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032317",
            "telephone_number": "812-353-9515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "811 E Parrish Ave",
            "address_purpose": "LOCATION",
            "city": "Owensboro",
            "state": "KY",
            "postal_code": "423033258",
            "country_code": "US",
            "telephone_number": "270-685-0216",
            "fax_number": "270-685-0683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DWYER",
        "first_name": "DAVID",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01069190A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "36271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64019482",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.