Dale Andrews Jr., PA-C
Individual provider Active NPI Surgical Physician Assistant · Greenwood, SC
NPI 1629616768 · NPPES record last updated Aug 20, 2025
Key facts
- NPI
- 1629616768
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Physician Assistant 363AS0400X
- License
- 5977 (SC)
- Practice address
- 1506 Spring St
Greenwood, SC 29646-4071 - Phone
- (864) 725-7900
- Fax
- (864) 725-7910
- NPI assigned
- Dec 19, 2019
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 8
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Self Medical Group
Practice addresses (Care Compare)
1325 Spring St
Greenwood, SC 29646-3860
Phone (864) 725-4111
1506 Spring St
Greenwood, SC 29646-4071
Phone (864) 725-7900
160 Academy Ave
Greenwood, SC 29646-3808
Phone (864) 223-8090
Hospital & facility affiliations
- Self Regional Healthcare
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NJ, SC
- 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 |
|---|---|---|---|---|
| I20231213003103 | NJ | Practitioner - Physician Assistant | 2466823513 | Reassigns benefits to 2 organizations |
| I20250911004445 | SC | Practitioner - Physician Assistant | 2466823513 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 027289 | NY | MD | Occupational Therapist |
| 5977 | SC | MD | Surgical Physician Assistant |
Practice roles (4 of 8)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rutgers Health-RWJ Neurosurgery Faculty | Current |
Accepting new patients | |
| Self Medical Group | Current |
Accepting new patients | |
| Rutgers Health-RWJ Neurosurgery Faculty | Current |
Accepting new patients | |
| Self Medical Group | Past | Accepting new patients |
Locations
75 Remittance Dr
Dept 6764
Chicago, IL 60675
1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887
125 Paterson St
Ste 4100
New Brunswick, NJ 08901
Phone (732) 235-7756
379 Campus Dr
Fl 4
Somerset, NJ 08873
Phone (732) 507-6545
104 Wells Ave
Greenwood, SC 29646
1325 Spring St
Greenwood, SC 29646
Phone (864) 227-4111
1506 Spring St
Greenwood, SC 29646
Phone (864) 227-3117
2605 Kinard St
Ste 200
Newberry, SC 29108
Phone (803) 276-1866
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
Interoperability endpoints
- dale.andrews.1@24989.direct.athenahealth.com
- dandrews1164593@nychhc.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 5977 | SC | Yes |
| Physician Assistant | 363A00000X | 027289 | NY |
Addresses
Primary practice location
1506 Spring St
Greenwood, SC 29646-4071
Mailing address
1325 Spring St
Greenwood, SC 29646-3875
Phone (864) 725-4673
Other practice location 1
130 Wadsworth Ave Apt 24
New York, NY 10033-4834
Phone (843) 325-0178
Other providers in Greenwood, SC
- Mary Parks Anderson
- Matthew Dean Anderson
- Sally D Anderson
- Tashara Anderson
- Steven M Andreasen
- Anesthesiology of Greenwood PA
- Angileks Home Care Services, LLC
- Elizabeth Antonia Ara
- Topanga Aradanas
- Taylor Marie Archambault
All providers in Greenwood, SC · Surgical Physician Assistant in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 20, 2025. 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.