Steven K Dahlke, MD. PEDIATRICS

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

50097 Issued in AZ

Practice address

1590 Paseo San Luis
Suite 102
Sierra Vista, AZ 85635-4782

Phone

(520) 459-0203

Fax

(520) 364-4261

NPI assigned

Oct 17, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: steven.dahlke.p1@direct.cchci.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Chiricahua Community Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Douglas, AZ
  • NPI 1942241443

  AZ

  Medicare reassignment NPD
• Chiricahua Community Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Douglas, AZ
  • NPI 1174820898
  NPD
• Chiricahua Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Willcox, AZ
  • NPI 1285488866
  NPD

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425945600000",
    "number": "1710976337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 F AVE",
            "city": "DOUGLAS",
            "state": "AZ",
            "postal_code": "856071920",
            "telephone_number": "520-364-1429",
            "fax_number": "520-364-4261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1590 PASEO SAN LUIS",
            "address_2": "SUITE 102",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856354782",
            "telephone_number": "520-459-0203",
            "fax_number": "520-364-4261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHLKE",
        "first_name": "STEVEN",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "credential": "MD. PEDIATRICS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2015-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ID",
            "license": "M7658",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "50097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805290700",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF ID",
            "identifier": "DX142",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "000010004986",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• CVS
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• Kelly Danielson
• Eva Danino, HADE14920
• Gwendoline Dapena, NP

• All providers in Sierra Vista, AZ
• Pediatrics Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.