Dustin K Wetmore, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA22901 Issued in CA

Practice address

121 Sotoyome St Ste 201
Santa Rosa, CA 95405

Phone

(707) 308-3101

Fax

(707) 546-4062

NPI assigned

Apr 11, 2013

Last updated

Nov 11, 2021By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

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, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Santa Rosa Memorial Hospital Hospital, Santa Rosa, CA, CCN 050174

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dwetmore1648055@oc.providencedirect.org

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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group
• Spectrumcare Rehabilitation Medical Center

  dba Napa Pain Institute

  • Pain Medicine Physician
  • Napa, CA
  • NPI 1477578201

  Physician Assistant

  Medicare reassignment NPD
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Woodlake, CA
  • NPI 1164517744
  Medicare reassignment
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Delano, CA
  • NPI 1063283158
  NPD
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Terra Bella, CA
  • NPI 1831520048
  NPD
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Strathmore, CA
  • NPI 1972010684
  NPD
• Providence Medical Foundation

  • Surgery Physician
  • Eureka, CA
  • NPI 1477790517
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD

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

• St. Joseph Health Northern California, LLC

  dba Providence Santa Rosa Memorial Hospital

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1134152549
  Care Compare affiliation

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

{
    "created_epoch": "1365638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1710320437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5510",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945810510",
            "telephone_number": "707-252-9660",
            "fax_number": "707-258-2780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 SOTOYOME ST STE 201",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95405",
            "telephone_number": "707-308-3101",
            "fax_number": "707-546-4062"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Lighthouse Ave",
            "address_purpose": "LOCATION",
            "city": "Monterey",
            "state": "CA",
            "postal_code": "939401439",
            "country_code": "US",
            "telephone_number": "831-649-0770",
            "fax_number": "831-649-0142",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 Lighthouse Ave",
            "address_purpose": "LOCATION",
            "city": "Monterey",
            "state": "CA",
            "postal_code": "939401439",
            "country_code": "US",
            "telephone_number": "831-649-0770",
            "fax_number": "831-649-0142",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1165 Montgomery Dr",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954054801",
            "country_code": "US",
            "telephone_number": "707-303-1709",
            "fax_number": "707-303-3912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WETMORE",
        "first_name": "DUSTIN",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-11",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA22901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dwetmore1648055@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "905 E Washington St",
            "city": "Petaluma",
            "state": "CA",
            "country_code": "US",
            "postal_code": "949523389",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• John Andrew Westhafer, PT
• Norman Paul Westhoff, M.D.
• Dale Raymond Westrom, M.D., PH.D.
• Judy Marie Wetch
• Angela Merrisa Wetmore, PA-C
• Nicole Wettach-Farias
• WHBC Midwives, Inc., a Nursing Corporation
• Catherine Ann Wheaton
• Wheelcare Express Inc.
• Wheelchair Transportation & Homecare Services LLC

• Physician Assistant in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2021; 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.