Individual provider Active NPI

Dean Brown, PA-C

  • Physician Assistant
  • Susanville, CA
National Provider Identifier
1417960352
Registry record updated Oct 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA13922 Issued in CA
Practice address
1850 Spring Ridge Dr
Susanville, CA 96130-6100
Phone
(530) 257-5563
Fax
(530) 257-6015
NPI assigned
Aug 14, 2006
Last updated
Oct 21, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA13922 CA Primary

Addresses

Primary practice location

1850 Spring Ridge Dr
Susanville, CA 96130-6100

Mailing address

1850 Spring Ridge Dr
Susanville, CA 96130-6100
Phone (530) 257-5563

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20091215000514 CA Practitioner - Physician Assistant 7315087780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Stanford University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1850 Spring Ridge Dr
Susanville, CA 96130-6100
Phone 53025150001515

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA13922CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern Rural Health Clinics CurrentSince Oct 11, 2009 Accepting new patients

Locations

1850 Spring Ridge Dr
Susanville, CA 96130
Phone (530) 251-5000

1850 Spring Ridge Dr
Ste 1850
Susanville, CA 96130

Organizations & group practices 2

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.

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": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224547200000",
    "number": "1417960352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 SPRING RIDGE DR",
            "city": "SUSANVILLE",
            "state": "CA",
            "postal_code": "961306100",
            "telephone_number": "530-257-5563",
            "fax_number": "530-257-6015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 SPRING RIDGE DR",
            "city": "SUSANVILLE",
            "state": "CA",
            "postal_code": "961306100",
            "telephone_number": "530-257-5563",
            "fax_number": "530-257-6015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "DEAN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2008-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA13922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Susanville, CA

Sources for this page

Verify at the official NPI Registry.