Elizabeth Diane Dassow, PA-C
Individual provider Active NPI Medical Physician Assistant · Fairfield, IA
NPI 1568097244 · NPPES record last updated Dec 7, 2022
Key facts
- NPI
- 1568097244
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- 106586 (IA)
- Practice address
- 2000 S Main St
Fairfield, IA 52556-9572 - Phone
- (641) 469-4204
- NPI assigned
- Mar 3, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 18
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- University of Wisconsin School of Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Jefferson County Hospital
Van Buren County Hospital
Practice addresses (Care Compare)
2000 S Main St
Fairfield, IA 52556-9572
Phone (641) 472-4111
304 Franklin St
Keosauqua, IA 52565-1164
Phone (319) 293-3171
Hospital & facility affiliations
- Jefferson County Health Center
- Washington County Hospital and Clinics
- Van Buren County Hospital
- Keokuk County Health Center
- Henry County Health Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210521000594 | IA | Practitioner - Physician Assistant | 8022436898 | Reassigns benefits to 8 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Washington County Hospital | Current |
Accepting new patients | |
| Washington County Hospital | Current | Accepting new patients | |
| Van Buren County Hospital | Current |
Accepting new patients | |
| Washington County Hospital | Single Specialty | Current |
Accepting new patients |
| Van Buren County Hospital | Single Specialty | Current |
Accepting new patients |
| Keokuk County Health Center | Current |
Accepting new patients | |
| Jefferson County Hospital | Current |
Accepting new patients | |
| Van Buren County Hospital | Current |
Accepting new patients | |
| Washington County Hospital | Single Specialty | Current |
Accepting new patients |
| Van Buren County Hospital | Single Specialty | Current |
Accepting new patients |
| Van Buren County Hospital | Past | Accepting new patients | |
| Jefferson County Hospital | Past | Accepting new patients |
Locations
2000 S Main St
Fairfield, IA 52556
Phone (641) 469-4204
304 Franklin St
Keosauqua, IA 52565
Phone (319) 293-3171
23019 Highway 149
Sigourney, IA 52591
Phone (641) 622-2720
400 E Polk St
Washington, IA 52353
Phone (319) 653-5481
Interoperability endpoints
- edassow236925@uihcdirect.org
- https://fhir-usa.unify.chbase.com/org/washin-6836dd27
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant |
363A00000X | 085007694 | IL | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Medical Physician Assistant | 363AM0700X | 106586 | IA | Yes |
Addresses
Primary practice location
2000 S Main St
Fairfield, IA 52556-9572
Mailing address
2233 W Hills Dr
Fairfield, IA 52556-4739
Other practice location 1
1229 C Ave E
Oskaloosa, IA 52577-4246
Phone (641) 780-3360
Other practice location 2
23019 Ia-149
Sigourney, IA 52591
Phone (641) 622-1170
Other practice location 3
1002 S Lincoln St
Knoxville, IA 50138-3121
Phone (641) 469-4204
Other practice location 4
400 E Polk St
Washington, IA 52353-1237
Phone (319) 863-3936
Other providers in Fairfield, IA
- Christina Cox
- Maurice Neil Crossland
- Laura Curran
- Richard Nielson Curtis
- Dae, Inc.
- Harbans Singh Deol
- Amber Dressler
- Megan Jane Earp
- Michael J. Eisner
- Mason James Ellis
All providers in Fairfield, IA · Medical Physician Assistant in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 7, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.