Dustin Van Wilkes, DO

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

P9487 Issued in TX

Practice address

1709 Martin Drive
Suite 100
Weatherford, TX 76086

Phone

(817) 594-5880

Fax

(806) 977-9112

NPI assigned

Apr 1, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Dermatology

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oliver Street 5.01(a) IncGroup PAC ID 0042464125, 169 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Oliver Street 5.01(a) Inc.

  • Dermatology Physician
  • Dallas, TX
  • NPI 1457695413
  Medicare reassignment Care Compare group NPD
• Cleaver Medical Group Dermatology Inc

  • Dermatology Physician
  • Cumming, GA
  • NPI 1841852076
  NPD
• Dermatology Associates

  • Dermatology Physician
  • Houston, TX
  • NPI 1356523039
  NPD (past)

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

{
    "created_epoch": "1301616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1497044291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 HARVEST HILL RD STE 290",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752305826",
            "telephone_number": "214-420-0672",
            "fax_number": "214-736-0512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 MARTIN DRIVE",
            "address_2": "SUITE 100",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "76086",
            "telephone_number": "817-594-5880",
            "fax_number": "806-977-9112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 Rockview Dr",
            "address_purpose": "LOCATION",
            "city": "Granbury",
            "state": "TX",
            "postal_code": "760495711",
            "country_code": "US",
            "telephone_number": "682-529-7800",
            "fax_number": "806-977-9112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILKES",
        "first_name": "DUSTIN",
        "middle_name": "VAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-01",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "P9487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dwilkes@conger.emadirect.md",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1709 Martin Drive",
            "address_2": "Suite 100",
            "city": "Weatherford",
            "state": "TX",
            "country_code": "US",
            "postal_code": "76086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alyssa Robyn Wheeler, PA
• Melinda White
• Wholeheart Counseling Services PLLC
• Ashten Marie Wiedebusch, LMSW
• Brenna Irene Wiles
• Addison Wilkins
• Caren R Williams, PHD, MED, LPC
• Michael Williams
• Jill Wilson
• Kari Renee Wilson, PA-C

• Dermatology Physician in Weatherford, TX
• Providers in Weatherford, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; 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.