Paul D Dearing, MD
Individual provider Active NPI Surgery Physician · Gillette, WY
NPI 1497789093 · NPPES record last updated Oct 10, 2007
Key facts
- NPI
- 1497789093
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgery Physician 208600000X
- License
- 6966A (WY)
- Practice address
- 501 S Burma Ave
2ND Floor
Gillette, WY 82716-3426 - Phone
- (307) 687-0030
- Fax
- (307) 687-0044
- NPI assigned
- Jul 10, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 9
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221104000746 | ND | Practitioner - General Surgery | 7012968571 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6966A | WY | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McKenzie County Healthcare Systems Inc | Current |
Accepting new patients | |
| McKenzie County Healthcare Systems Inc | Surgery | Current |
Accepting new patients |
| McKenzie County Healthcare Systems Inc | Past | Accepting new patients | |
| Pediatric Hematology Oncology Pharmacy LTC | Past | Accepting new patients | |
| McKenzie County Healthcare Systems Inc | Past | Accepting new patients | |
| McKenzie County Healthcare Systems Inc | Past | Accepting new patients | |
| Pediatric Hematology Clinic LTD | Past | Accepting new patients | |
| McKenzie County Healthcare Systems Inc | Past | Accepting new patients | |
| McKenzie County Healthcare Systems Inc | Past | Accepting new patients |
Locations
709 4th Ave NE
Watford City, ND 58854
Phone (701) 444-2331
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 6966A | WY | Yes |
Addresses
Primary practice location
501 S Burma Ave
2ND Floor
Gillette, WY 82716-3426
Mailing address
PO Box 3799
Gillette, WY 82717-3799
Phone (307) 687-0030
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 313290 | Other | WY | BLUE CROSS BLUE SHIELD WY |
Other providers in Gillette, WY
- Bethany Davis
- Cameron Wayne Davis
- Thomas Clifford Davis
- Nancy Day
- Jean-Raphael De Raoulx
- Chrissy Michael Deavor
- Laurence William Vale Deboer
- Britta L Denman
- Dental Care Center PC
- Wendy Depina
All providers in Gillette, WY · Surgery Physician in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.