NPIMap

Individual provider Active NPI

Ephraim Dickinson, M.D.

  • Orthopaedic Surgery Physician
  • Ukiah, CA
National Provider Identifier
1386957785
Registry record updated May 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
A121228 Issued in CA
Practice address
260 Hospital Dr Ste 107
Ukiah, CA 95482
Phone
(707) 467-5278
NPI assigned
Jul 15, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 2015-00873 NC
Orthopaedic Surgery Physician 207X00000X A121228 CA Primary

Addresses

Primary practice location

260 Hospital Dr Ste 107
Ukiah, CA 95482

Mailing address

260 Hospital Dr Ste 107
Ukiah, CA 95482-4568

Other identifiers 2

IdentifierTypeStateIssuer
NC2420MedicaidSC
1386957785MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171106001524 CA Practitioner - Orthopedic Surgery 3274845656 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Columbia University College of Physicians and Surgeons, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pacific Crest Orthopedics PCGroup PAC ID 1951469212, 4 clinicians

Practice addresses (Care Compare)

2100 Webster St
Suite 331
San Francisco, CA 94115-2378
Phone (415) 923-0944

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A121228CAMDOrthopaedic Surgery Physician
2015-00873NCMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Crest Orthopedics PC CurrentSince Nov 24, 2022 Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients
St. Mary's Health, Inc. Past Accepting new patients
Tahoe Forest Hospital District Past Accepting new patients
St. Mary's Medical Center Past Accepting new patients
UCSF Health Community Hospitals Past Accepting new patients
UCSF Health Community Hospitals Past Accepting new patients

Locations

2205 Post St
San Francisco, CA 94115
Phone (315) 256-4903

2100 Webster St
Ste 331
San Francisco, CA 94115
Phone (415) 600-7892

3000 California St
#3
San Francisco, CA 94115
Phone (415) 292-9528

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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 4

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": "1279152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526947200000",
    "number": "1386957785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 HOSPITAL DR STE 107",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954824568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 HOSPITAL DR STE 107",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "95482",
            "telephone_number": "707-467-5278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKINSON",
        "first_name": "EPHRAIM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-15",
        "last_updated": "2018-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "2015-00873",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A121228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC2420",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1386957785",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ukiah, CA

Sources for this page

Verify at the official NPI Registry.