Individual provider Active NPI

Paul L Dandrea, M.D.

  • Aerospace Medicine Physician
  • Travis Afb, CA
National Provider Identifier
1750381109
Registry record updated Jan 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Aerospace Medicine PhysicianTaxonomy code 2083A0100X
License
28489 Issued in AZ
Practice address
101 Bodin Cir
Travis Afb, CA 94535-1809
Phone
(707) 423-7342
NPI assigned
Jul 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Aerospace Medicine Physician 2083A0100X 28489 AZ Primary

Addresses

Primary practice location

101 Bodin Cir
Travis Afb, CA 94535-1809

Mailing address

101 Bodin Cir
Travis Afb, CA 94535-1809
Phone (707) 423-7342

Other identifiers 1

IdentifierTypeStateIssuer
535908MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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

Enrollment IDStateProvider typePAC IDDetails
I20130328000228 NM Order and Referring Only - Family PracticePractitioner - Preventive MedicinePractitioner - Family Practice 4486661659

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Cardiac Specialists, Chartered Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769040000000",
    "number": "1750381109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-7342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-7342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANDREA",
        "first_name": "PAUL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "AZ",
            "license": "28489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "535908",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Travis Afb, CA

Sources for this page

Verify at the official NPI Registry.