Individual provider Active NPI

Dale Vernon Wyville, P.A.

  • Physician Assistant
  • Rancho Mirage, CA
National Provider Identifier
1528075934
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
59022 Issued in CA
Practice address
40075 Bob Hope Dr Ste a
Rancho Mirage, CA 92270-3945
Phone
(760) 341-3688
Fax
(760) 341-8992
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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 59022 CA Primary

Addresses

Primary practice location

40075 Bob Hope Dr Ste a
Rancho Mirage, CA 92270-3945

Mailing address

39000 Bob Hope Dr
Rancho Mirage, CA 92270-3221
Phone (760) 341-3688

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
I20210412001078 CA Practitioner - Physician Assistant 5193827152 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Eisenhower Medical CenterGroup PAC ID 5890689657, 462 clinicians

Practice addresses (Care Compare)

39000 Bob Hope Dr
Rancho Mirage, CA 92270-3221
Phone (760) 340-3911

39950 Vista del Sol
Rancho Mirage, CA 92270-3206
Phone (760) 340-0053

Hospital & facility affiliations

  • Eisenhower Medical Center Hospital, Rancho Mirage, CA, CCN 050573

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
59022CAMDHematology & Oncology Physician
012424NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Eisenhower Medical Center CurrentSince Apr 26, 2021 Accepting new patients
New York Westchester SQ Med Ctr Past Accepting new patients
Eisenhower Medical Center Past Accepting new patients
Holy Cross Hospital Past Accepting new patients

Locations

72201 Country Club Dr
Rancho Mirage, CA 92270
Phone (760) 340-5999

39000 Bob Hope Dr
Rancho Mirage, CA 92270
Phone (760) 340-3911

40075 Bob Hope Dr
Ste A
Rancho Mirage, CA 92270
Phone (760) 340-3911

39000 Bob Hope Dr
Ofc
Rancho Mirage, CA 92270
Phone (760) 333-1813

39950 Vista del Sol
Rancho Mirage, CA 92270
Phone (760) 340-0053

Interoperability endpoints

  • Direct secure messaging: dwyville105322@edirect.emc.org

Organizations & group practices 4

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 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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1528075934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DR",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703221",
            "telephone_number": "760-341-3688",
            "fax_number": "760-341-8992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40075 BOB HOPE DR STE A",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703945",
            "telephone_number": "760-341-3688",
            "fax_number": "760-341-8992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYVILLE",
        "first_name": "DALE",
        "middle_name": "VERNON",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "59022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

Verify at the official NPI Registry.