NPIMap

Individual provider Active NPI

Monica Marie Dittmer, PAC

  • Physician Assistant
  • High Point, NC
National Provider Identifier
1730168055
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4515 Premier Dr Ste 404
High Point, NC 27265-8356
Phone
(336) 802-2085
Fax
(336) 802-2086
NPI assigned
Jan 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 000102624 NC
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

4515 Premier Dr Ste 404
High Point, NC 27265-8356

Mailing address

1701 Westchester Dr Ste 850
High Point, NC 27262-7254
Phone (336) 716-1331

Other practice location 1

145 Kimel Park Dr
Suite 330
Winston Salem, NC 27103-6984
Phone (336) 765-6181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110125000896 NC Practitioner - Physician Assistant 2668651407 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
000102624NCMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Firsthealth of the Carolinas, Inc Dba Firsthealth Weight Management Clinic CurrentSince Apr 17, 2012 Accepting new patients
FHPG, LLC CurrentSince Jan 1, 2015 Accepting new patients
Firsthealth of the Carolinas, Inc. CurrentSince Apr 17, 2012 Accepting new patients
Cornerstone Health Care LLC CurrentSince Aug 18, 2014 Accepting new patients
FHPG, LLC CurrentSince Jan 1, 2015 Accepting new patients
Wake Forest Health Network, LLC CurrentSince Aug 18, 2014 Accepting new patients
Wake Forest University Health Sciences CurrentSince Jul 1, 2002 Accepting new patients

Locations

905 Phillips Ave
High Point, NC 27262
Phone (336) 802-2040

4515 Premier Dr
Ste 404
High Point, NC 27265
Phone (336) 802-2085

1701 Westchester Dr
Ste 850
High Point, NC 27262
Phone (336) 802-2400

606 N Elm St
High Point, NC 27262
Phone (336) 884-0224

223 Hospital St
Mocksville, NC 27028
Phone (336) 751-8100

923 W 3rd St
Pembroke, NC 28372
Phone (910) 521-0564

155 Memorial Dr
Pinehurst, NC 28374
Phone (910) 215-1000

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947

Interoperability endpoints

  • Direct secure messaging: mdittmer2755336@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 10

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.

Hospital & facility affiliations 6

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": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1730168055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 WESTCHESTER DR STE 850",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272627254",
            "telephone_number": "336-716-1331",
            "fax_number": "336-716-3202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 PREMIER DR STE 404",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272658356",
            "telephone_number": "336-802-2085",
            "fax_number": "336-802-2086"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "145 Kimel Park Dr",
            "address_2": "Suite 330",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271036984",
            "country_code": "US",
            "telephone_number": "336-765-6181",
            "fax_number": "336-765-8492",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DITTMER",
        "first_name": "MONICA",
        "middle_name": "MARIE",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-13",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "000102624",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

Verify at the official NPI Registry.