Individual provider Active NPI

Timothy Steffen Dahl, PA-C

  • Surgical Physician Assistant
  • Charleston, SC
National Provider Identifier
1518567601
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
25MP00588500 Issued in NJ
Practice address
501 Salt Wedge Dr Unit 5301
Charleston, SC 29492-9025
Phone
(347) 964-3084
NPI assigned
Oct 28, 2020
Last updated
Oct 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 25MP00588500 NJ
Surgical Physician Assistant 363AS0400X PA101814 MA
Surgical Physician Assistant 363AS0400X 25MP00588500 NJ Primary

Addresses

Primary practice location

501 Salt Wedge Dr Unit 5301
Charleston, SC 29492-9025

Mailing address

501 Salt Wedge Dr Unit 5301
Charleston, SC 29492-9025
Phone (347) 964-3084

Other practice location 1

50 Wason Ave Fl 2
Springfield, MA 01107-1280
Phone (413) 794-1800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201030001863 NJ Practitioner - Physician Assistant 7719397827 Reassigns benefits to 1 organization
I20251029002105 MA Practitioner - Physician Assistant 7719397827 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

50 Wason Ave
FL 2
Springfield, MA 01107-1280
Phone (413) 794-1800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA101814MAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Premier PA Consulting, LLC Surgical CurrentSince Sep 6, 2025 Accepting new patients
Advanced Gynecology and Laparoscopy of North Jersey, PC CurrentSince Nov 1, 2020 Accepting new patients

Locations

50 Wason Ave
Fl 2
Springfield, MA 01107
Phone (413) 286-1020

2025 Hamburg Tpke
Ste C
Wayne, NJ 07470
Phone (201) 572-7982

9313 Medical Plaza Dr
Ste 102
North Charleston, SC 29406
Phone (843) 572-1228

Interoperability endpoints

  • Direct secure messaging: timothy.dahl.1@21449.direct.athenahealth.com

Organizations & group practices 3

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 2

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": "1603843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1518567601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 SALT WEDGE DR UNIT 5301",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294929025",
            "telephone_number": "347-964-3084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 SALT WEDGE DR UNIT 5301",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294929025",
            "telephone_number": "347-964-3084"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Wason Ave Fl 2",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MA",
            "postal_code": "011071280",
            "country_code": "US",
            "telephone_number": "413-794-1800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAHL",
        "first_name": "TIMOTHY",
        "middle_name": "STEFFEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-28",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00588500",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "PA101814",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00588500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.