NPIMap

Individual provider Active NPI

Aaron Nicholas Dodge, PA-C

  • Physician Assistant
  • Cape Girardeau, MO
National Provider Identifier
1568003622
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2019034866 Issued in MO
Practice address
3250 Gordonville Rd Ste 384
Cape Girardeau, MO 63703-5095
Phone
(573) 331-5522
Fax
(573) 331-5523
NPI assigned
Sep 30, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2021

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 2019034866 MO Primary

Addresses

Primary practice location

3250 Gordonville Rd Ste 384
Cape Girardeau, MO 63703-5095

Mailing address

PO Box 801143
Kansas City, MO 64180-1143
Phone (573) 331-5583

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191125000394 MO Practitioner - Physician Assistant 8426480898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Francis Medical CenterGroup PAC ID 9931007929, 441 clinicians

Practice addresses (Care Compare)

150 S Mount Auburn Rd
Cape Girardeau, MO 63703-5049

211 Saint Francis Dr
Cape Girardeau, MO 63703-5049

211 Saint Francis Dr
Cape Girardeau, MO 63703-8399

24 S Mount Auburn Rd
Cape Girardeau, MO 63703-5049

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
67.07 of 100Reported as apm
Quality
85.4
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Francis Medical Center CurrentSince Nov 11, 2019 Accepting new patients
Saint Francis Medical Center Physician Assistant CurrentSince Nov 11, 2019 Accepting new patients
Saint Francis Medical Center Past Accepting new patients

Locations

3250 Gordonville Rd
Ste 384
Cape Girardeau, MO 63703
Phone (573) 331-5522

211 Saint Francis Dr
Cpe Girardeau, MO 63703
Phone (573) 331-3000

Interoperability endpoints

  • Direct secure messaging: adodge94277@surescripts.sfmc.net

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 5

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": "1569801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1568003622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801143",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641801143",
            "telephone_number": "573-331-5583",
            "fax_number": "573-331-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 GORDONVILLE RD STE 384",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637035095",
            "telephone_number": "573-331-5522",
            "fax_number": "573-331-5523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODGE",
        "first_name": "AARON",
        "middle_name": "NICHOLAS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-30",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2019034866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.