Individual provider Active NPI

Eric M Dolash, PA-C

  • Physician Assistant
  • Waterloo, IA
National Provider Identifier
1497162143
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
073312 Issued in IA
Practice address
3741 Pheasant LN
Waterloo, IA 50701-5215
Phone
(319) 234-6000
Fax
(319) 234-6001
NPI assigned
Jul 15, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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 073312 IA Primary

Addresses

Primary practice location

3741 Pheasant LN
Waterloo, IA 50701-5215

Mailing address

PO Box 2400
Waterloo, IA 50704-2400
Phone (319) 234-6000

Other practice location 1

312 9th St SW Ste 2000
Waverly, IA 50677-2909
Phone (319) 234-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20140929000234 IA Practitioner - Physician Assistant 0345460283 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Dermatology LTDGroup PAC ID 3173765294, 3 clinicians

Practice addresses (Care Compare)

312 9TH St SW
2000 Dermatology Clinic
Waverly, IA 50677-2909
Phone (319) 234-6000

3741 Pheasant LN
Waterloo, IA 50701-5215
Phone (319) 234-6000

441 E San Marnan Dr
Suite 110
Waterloo, IA 50702-5900
Phone (319) 234-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.87 of 100Reported as group
Quality
93.47
Promoting interoperability
100
Improvement activities
40
Cost
82.77

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
073312IAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Orthopaedic Center, P.C. Physician Assistant CurrentSince Aug 19, 2014 Accepting new patients
Iowa Orthopaedic Center, P.C. CurrentSince Aug 19, 2014 Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients

Locations

450 Laurel St
Ste C
Des Moines, IA 50314
Phone (515) 247-9590

450 Laurel St
Ste A
Des Moines, IA 50314
Phone 5152478400321

Interoperability endpoints

  • Direct secure messaging: edolash@premierderm.emadirect.md

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 3

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": "1405382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1497162143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2400",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507042400",
            "telephone_number": "319-234-6000",
            "fax_number": "319-234-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3741 PHEASANT LN",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507015215",
            "telephone_number": "319-234-6000",
            "fax_number": "319-234-6001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "312 9th St SW Ste 2000",
            "address_purpose": "LOCATION",
            "city": "Waverly",
            "state": "IA",
            "postal_code": "506772909",
            "country_code": "US",
            "telephone_number": "319-234-6000",
            "fax_number": "319-234-6001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOLASH",
        "first_name": "ERIC",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-15",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "073312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.