Debra A Dewall, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1042 Issued in CO

Practice address

1675 18TH Ave Ste 3
Greeley, CO 80631

Phone

(970) 347-5780

Fax

(970) 347-5797

NPI assigned

May 28, 2006

Last updated

Sep 5, 2018By the provider in NPPES

Sex

Female

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 2

Medicare fee-for-service enrollment

Enrolled in CO

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 1

Specialty

Physician Assistant

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medical Center of the Rockies Hospital, Loveland, CO, CCN 060119
• Uchealth Greeley Hospital Hospital, Greeley, CO, CCN 060131
• Poudre Valley Hospital Hospital, Fort Collins, CO, CCN 060010
• Longs Peak Hospital Hospital, Longmont, CO, CCN 060128

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Poudre Valley Medical Group, LLC

  dba UCHealth Medical Group

  • General Practice Physician
  • Loveland, CO
  • NPI 1225356868
  Medicare reassignment Care Compare group
• Poudre Valley Medical Group, LLC

  dba UCHealth Medical Group

  • General Practice Physician
  • Loveland, CO
  • NPI 1366763260
  NPD
• Poudre Valley Medical Group, LLC

  dba UCHealth Medical Group

  • Hematology & Oncology Physician
  • Loveland, CO
  • NPI 1033905856
  NPD (past)

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

• Longs Peak Hospital

  • General Acute Care Hospital
  • Longmont, CO
  • NPI 1154876985
  Care Compare affiliation
• Medical Center of the Rockies

  dba Greeley Emergency Center

  • General Acute Care Hospital
  • Greeley, CO
  • NPI 1104262286
  Care Compare affiliation
• Medical Center of the Rockies

  • General Acute Care Hospital
  • Loveland, CO
  • NPI 1750392304
  Care Compare affiliation
• Medical Center of the Rockies

  • General Acute Care Hospital
  • Greeley, CO
  • NPI 1780243055
  Care Compare affiliation
• Poudre Valley Health Care Inc

  dba Poudre Valley Hospital

  • General Acute Care Hospital
  • Greeley, CO
  • NPI 1679419808
  Care Compare affiliation
• Poudre Valley Health Care Inc

  dba Poudre Valley Health System

  • General Acute Care Hospital
  • Greeley, CO
  • NPI 1962158857
  Care Compare affiliation
• Poudre Valley Health Care Inc.

  dba Poudre Valley Hospital

  • General Acute Care Hospital
  • Fort Collins, CO
  • NPI 1073172094
  Care Compare affiliation
• Poudre Valley Health Care Inc.

  dba Poudre Valley Hospital

  • General Acute Care Hospital
  • Fort Collins, CO
  • NPI 1093374001
  Care Compare affiliation
• Poudre Valley Health Care Inc.

  dba Poudre Valley Hospital

  • General Acute Care Hospital
  • Fort Collins, CO
  • NPI 1093374092
  Care Compare affiliation
• Poudre Valley Health Care Inc.

  dba Poudre Valley Hospital

  • General Acute Care Hospital
  • Fort Collins, CO
  • NPI 1114586278
  Care Compare affiliation
• Poudre Valley Health Care Inc.

  dba Poudre Valley Hospital

  • General Acute Care Hospital
  • Fort Collins, CO
  • NPI 1184283103
  Care Compare affiliation
• Poudre Valley Health Care Inc.

  dba UCHealth Lifeline

  • General Acute Care Hospital
  • Aurora, CO
  • NPI 1225610389
  Care Compare affiliation

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536105600000",
    "number": "1689621195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 18TH AVE STE 3",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806315151",
            "telephone_number": "970-347-5780",
            "fax_number": "970-347-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 18TH AVE STE 3",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "80631",
            "telephone_number": "970-347-5780",
            "fax_number": "970-347-5797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2121 E Harmony Rd Unit 170",
            "address_purpose": "LOCATION",
            "city": "Fort Collins",
            "state": "CO",
            "postal_code": "805283413",
            "country_code": "US",
            "telephone_number": "970-493-6337",
            "fax_number": "970-493-3528",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2500 Rocky Mountain Ave",
            "address_purpose": "LOCATION",
            "city": "Loveland",
            "state": "CO",
            "postal_code": "805389004",
            "country_code": "US",
            "telephone_number": "970-203-7080",
            "fax_number": "970-203-7085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEWALL",
        "first_name": "DEBRA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-28",
        "last_updated": "2018-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "1042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD CARRIER PTAN",
            "identifier": "P00944843",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "57332550",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Raymonde Destine Compere
• Ben Deturk, MI
• Hannah Dewild, BA
• Michelle Dewitt
• Dexter Creek Healthcare, Inc. (Broadview Health and Rehabilitation Center)
• Dexter Creek Healthcare, Inc. (Broadview Health and Rehabilitation Center)
• Danielle Deyoung

• Physician Assistant in Greeley, CO
• Providers in Greeley, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2018; 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.