Dana Van Wyck

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

4776 N Five Mile Rd
Boise, ID 83713-2715

Phone

(208) 658-9500

NPI assigned

Jul 8, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Creighton University School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New Motion Physical Therapy, Inc., PSGroup PAC ID 9638162993, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• New Motion Physical Therapy, Inc., PS

  • Physical Therapist
  • Bainbridge Island, WA
  • NPI 1578518668
  Medicare reassignment Care Compare group NPD
• Revolutionary Medicine of Idaho

  • Family Nurse Practitioner
  • Boise, ID
  • NPI 1487493292
  NPD (past)

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

{
    "created_epoch": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1528620853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9419 COPPERTOP LOOP NE",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981103647",
            "telephone_number": "206-842-2428",
            "fax_number": "206-842-2890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4776 N FIVE MILE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837132715",
            "telephone_number": "208-658-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN WYCK",
        "first_name": "DANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-08",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Jane Van Leuven I, LCPC, NCC
• Katie Elizabeth Van Lier, PA-C
• Mariellen C Van Nieuwenhuyzen, MD
• Van Sickle Chiropractic LLC
• Katie Marie Van Tassell, LPC
• Jamie Lynn Van, LPC
• Pamela Vance, CRC, LPC
• Ryan R Vance, RD, LD
• Tyler Vance, DO
• Paul Vandaele, MA; LPC

• Physical Therapist in Boise, ID
• Providers in Boise, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.