Individual provider Active NPI

Dale Andrews Jr., PA-C

  • Surgical Physician Assistant
  • Greenwood, SC
National Provider Identifier
1629616768
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
5977 Issued in SC
Practice address
1506 Spring St
Greenwood, SC 29646-4071
Phone
(864) 725-7900
Fax
(864) 725-7910
NPI assigned
Dec 19, 2019
Last updated
Aug 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 5977 SC Primary
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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, SC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231213003103 NJ Practitioner - Physician Assistant 2466823513 Reassigns benefits to 2 organizations
I20250911004445 SC Practitioner - Physician Assistant 2466823513 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Self Medical GroupGroup PAC ID 6002953916, 393 clinicians

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
027289NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health-RWJ Neurosurgery Faculty CurrentSince Jul 1, 2024 Accepting new patients
Self Medical Group CurrentSince Sep 1, 2025 Accepting new patients
Rutgers Health-RWJ Neurosurgery Faculty CurrentSince Jul 1, 2024 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 H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: dale.andrews.1@24989.direct.athenahealth.com
  • Direct secure messaging: dandrews1164593@nychhc.direct-ci.com

Organizations & group practices 6

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 4

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": "1576713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1629616768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 SPRING ST",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296463875",
            "telephone_number": "864-725-4673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 SPRING ST",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296464071",
            "telephone_number": "864-725-7900",
            "fax_number": "864-725-7910"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 Wadsworth Ave Apt 24",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100334834",
            "country_code": "US",
            "telephone_number": "843-325-0178",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDREWS",
        "first_name": "DALE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-19",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "SC",
            "license": "5977",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "027289",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, SC

Sources for this page

Verify at the official NPI Registry.