NPIMap

Individual provider Active NPI

Todd C. Dean, PA-C

  • Physician Assistant
  • Springfield, MO
National Provider Identifier
1629117361
Registry record updated Nov 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2003022693 Issued in MO
Practice address
1229 E Seminole St
Ste 230
Springfield, MO 65804-2227
Phone
(417) 820-5610
NPI assigned
Feb 6, 2007
Last updated
Nov 27, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2012

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 2003022693 MO Primary

Addresses

Primary practice location

1229 E Seminole St
Ste 230
Springfield, MO 65804-2227

Mailing address

PO Box 2580
Springfield, MO 65801-2580
Phone (417) 829-4620

Other identifiers 1

IdentifierTypeStateIssuer
P00076285OtherMORR MCR

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
I20120110000401 MO Practitioner - Physician Assistant 5698941839 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

1235 E Cherokee St
Springfield, MO 65804-2203

1605 Martin Springs Dr
Rolla, MO 65401-2980

2115 S Fremont Ave
Springfield, MO 65804-2232

2115 S Fremont Ave
1100 MC Womens Oncology Whiteside
Springfield, MO 65804-2239
Phone (417) 820-3554

2115 S Fremont Ave
3050 MC Infectious Disease Whiteside
Springfield, MO 65804-2236
Phone (417) 820-3905

2135 S Fremont Ave
MC Physical Med and Rehab
Springfield, MO 65804-2239
Phone (417) 820-2364

3050 E River Bluff Blvd
MC Orthopedics
Ozark, MO 65721-8807
Phone (417) 820-5610

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2003022693MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Jul 16, 2012 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Sep 28, 2013 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Jul 16, 2012 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

3050 E River Bluff Blvd
Ozark, MO 65721
Phone (417) 820-5610

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

2115 S Fremont Ave
Ste 4300
Springfield, MO 65804
Phone (417) 829-3911

620 S Glenstone Ave
Springfield, MO 65802
Phone (417) 829-4215

Interoperability endpoints

  • Direct secure messaging: tdean18251@directc.mercy.net
  • Direct secure messaging: tdean729@directb.mercy.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353974400000",
    "number": "1629117361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2580",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658012580",
            "telephone_number": "417-829-4620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1229 E SEMINOLE ST",
            "address_2": "STE 230",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042227",
            "telephone_number": "417-820-5610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAN",
        "first_name": "TODD",
        "middle_name": "C.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2012-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2003022693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "P00076285",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.