NPIMap

Individual provider Active NPI

Andrea Michelle Dale, MD

  • Family Medicine Physician
  • Independence, OH
National Provider Identifier
1770902777
Registry record updated Aug 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35.133720 Issued in OH
Practice address
6801 Brecksville Rd Ste 10
Independence, OH 44131-5057
Phone
(216) 636-8742
NPI assigned
Apr 8, 2014
Last updated
Aug 9, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35.133720 OH Primary

Addresses

Primary practice location

6801 Brecksville Rd Ste 10
Independence, OH 44131-5057

Mailing address

6801 Brecksville Rd Ste 10
Independence, OH 44131-5057
Phone (166) 368-8742

Other practice location 1

2400 W Villard Ave
Milwaukee, WI 53209-4901
Phone (414) 527-8348

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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
I20221121000941 VT Practitioner - Family Practice 3577851104 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Country Hospital and Health Center IncGroup PAC ID 9739073479, shared by 8 NPIs, 50 clinicians

Practice addresses (Care Compare)

186 Medical Village Dr
Newport, VT 05855-8537
Phone (802) 334-3520

186 Medical Village Dr
Suite 1
Newport, VT 05855-9326

189 Prouty Dr
Newport, VT 05855-9326

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.39 of 100Reported as group
Quality
72.51
Promoting interoperability
100
Improvement activities
40
Cost
55.45

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Country Hospital & Health Center Inc Family Medicine Current Accepting new patients
North Country Hospital & Health Center Inc CurrentSince Oct 17, 2022 Accepting new patients
North Country Hospital & Health Center Inc Current Accepting new patients
North Country Hospital & Health Center Inc CurrentSince Oct 17, 2022 Accepting new patients

Locations

186 Medical Village Dr
Newport, VT 05855
Phone (802) 334-3520

186 Medical Village Dr
#1
Newport, VT 05855
Phone (802) 334-3262

189 Prouty Dr
Newport, VT 05855
Phone (802) 334-3569

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4a15a283-6747-4ef7-984f-ce0e904fd6f0/

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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": "1396915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533772800000",
    "number": "1770902777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 BRECKSVILLE RD STE 10",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441315057",
            "telephone_number": "166-368-8742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 BRECKSVILLE RD STE 10",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441315057",
            "telephone_number": "216-636-8742"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 W Villard Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532094901",
            "country_code": "US",
            "telephone_number": "414-527-8348",
            "fax_number": "414-527-8046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DALE",
        "first_name": "ANDREA",
        "middle_name": "MICHELLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-08",
        "last_updated": "2018-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.133720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, OH

Sources for this page

Verify at the official NPI Registry.