James Theodore Dodge Jr., MD

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

MD00031058 Issued in WA

Practice address

1201 S Miller St Ste a
Wenatchee, WA 98801-3201

Phone

(509) 663-8711

NPI assigned

Jun 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Dr. J Theodore Dodge Jr. Professional name

Medicare fee-for-service enrollment

Enrolled in WA

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 1

Specialty

Interventional CardiologyAlso: Internal Medicine

Education

University of Washington School of Medicine, 1991

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)

Hospital & facility affiliations

• Yakima Valley Memorial Hospital, Yakima, WA, CCN 500036
• Confluence Health Hospital Hospital, Wenatchee, WA, CCN 500016

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jdodge2896@edirect.chehr.org

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.

• Multicare Health System

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  Medicare reassignment Care Compare group NPD
• Wenatchee Valley Hospital

  • Multi-Specialty Clinic/Center
  • Wenatchee, WA
  • NPI 1669719688
  Medicare reassignment NPD
• Central Washington Health Services Association

  • Emergency Medical Services (Emergency Medicine) Physician
  • Wenatchee, WA
  • NPI 1801937453
  NPD
• Multicare Health System

  • Family Medicine Physician
  • Tacoma, WA
  • NPI 1396297487
  NPD
• Multicare Health System

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Central Washington Health Services Association

  • General Acute Care Hospital
  • Wenatchee, WA
  • NPI 1306883228
  Care Compare affiliation
• Yakima Valley Memorial Hospital Association

  • General Acute Care Hospital
  • Yakima, WA
  • NPI 1053373480
  Care Compare affiliation

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436832000000",
    "number": "1619905429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 N CHELAN AVE",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012028",
            "telephone_number": "509-663-8711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S MILLER ST STE A",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988013201",
            "telephone_number": "509-663-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODGE",
        "first_name": "JAMES",
        "middle_name": "THEODORE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2015-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "WA",
            "license": "MD00031058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WVH LNI",
            "identifier": "315914",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE WVH",
            "identifier": "P01256388",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619905429",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "J",
            "last_name": "DODGE",
            "middle_name": "THEODORE",
            "prefix": "DR.",
            "suffix": "JR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• McKenzie Taylor Dillon, LMHCA
• Thomas Dillon, MD
• Mary Nicole Dimaano, PHARMD
• Jesse Aidan Dinh
• John Robert Divis, DDS
• Michelle L Dodge
• Jordan Michael Doerr, MD
• Kristen K. Doerr, ARNP
• Jonathan E Dominguez, MD
• Roberto Dominguez Sr.

• Interventional Cardiology Physician in Wenatchee, WA
• Providers in Wenatchee, WA by specialty
• Interventional Cardiology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.