Individual provider Active NPI

Miles McBride Dale, M.D.

  • Surgery Physician
  • Puyallup, WA
National Provider Identifier
1558899005
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD61453759 Issued in WA
Practice address
1519 3Rd St SE Ste 230
Puyallup, WA 98372-3742
Phone
(253) 841-9640
Fax
(253) 841-7645
NPI assigned
May 30, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD61453759 WA Primary

Addresses

Primary practice location

1519 3Rd St SE Ste 230
Puyallup, WA 98372-3742

Mailing address

PO Box 5299
Ms: 820-5-Pco
Tacoma, WA 98415-0299

Other practice location 1

90 Prospect Ave Ste 1D
Hackensack, NJ 07601-1918
Phone (201) 977-4840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220921000167 NJ Practitioner - General Surgery 2567847999 Reassigns benefits to 1 organization
I20231108001774 WA Practitioner - General Surgery 2567847999 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
New York Medical College, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

407 14TH Ave SE
Puyallup, WA 98372-3770
Phone (253) 697-1962

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Oct 16, 2023 Accepting new patients
One Surgical Specialists Surgery CurrentSince Aug 1, 2022 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Oct 16, 2023 Accepting new patients
Multicare Health System Past Accepting new patients

Locations

90 Prospect Ave
Ste 1D
Hackensack, NJ 07601
Phone (201) 343-3433

2 Sears Dr
Ste 202
Paramus, NJ 07652
Phone (201) 343-3433

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

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": "1496102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1558899005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5299",
            "address_2": "MS: 820-5-PCO",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984150299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1519 3RD ST SE STE 230",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723742",
            "telephone_number": "253-841-9640",
            "fax_number": "253-841-7645"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "90 Prospect Ave Ste 1D",
            "address_purpose": "LOCATION",
            "city": "Hackensack",
            "state": "NJ",
            "postal_code": "076011918",
            "country_code": "US",
            "telephone_number": "201-977-4840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DALE",
        "first_name": "MILES",
        "middle_name": "MCBRIDE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-30",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD61453759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.