NPIMap

Individual provider Active NPI

Douglas C Dycus, M.D.

  • Internal Medicine Physician
  • Gainesboro, TN
National Provider Identifier
1780601708
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD020847 Issued in TN
Practice address
3698 S Grundy Quarles Hwy
Gainesboro, TN 38562-5950
Phone
(931) 268-3224
Fax
(931) 268-3228
NPI assigned
Jul 16, 2006
Last updated
Jun 2, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD020847 TN Primary

Addresses

Primary practice location

3698 S Grundy Quarles Hwy
Gainesboro, TN 38562-5950

Mailing address

PO Box 247
Gainesboro, TN 38562-0247
Phone (931) 268-3224

Other identifiers 2

IdentifierTypeStateIssuer
3057264MedicaidTN
142892OtherTNBC/BSTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20100823000302 TN Practitioner - Internal Medicine 2062402522 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Tennessee, HSC, College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3698 S Grundy Quarles Hwy
Gainesboro, TN 38562-5950
Phone (931) 268-3224

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.06 of 100Reported as individual
Quality
90.69
Improvement activities
40
Cost
79.28

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD020847TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Douglas Dycus Internal Medicine CurrentSince Oct 1, 2000 Accepting new patients
Cookeville Regional Medical Group, Inc CurrentSince Jul 1, 2022 Accepting new patients
Cookeville Regional Medical Center Past Accepting new patients

Locations

1 Medical Center Blvd
Cookeville, TN 38501
Phone (931) 783-2334

100 W 4th St
Ste 350
Cookeville, TN 38501
Phone (931) 646-2901

140 W 7th St
Cookeville, TN 38501
Phone (931) 783-5582

3698 S Grundy Quarles Hwy
Gainesboro, TN 38562
Phone (931) 268-3224

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10383/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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 11

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": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1780601708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 247",
            "city": "GAINESBORO",
            "state": "TN",
            "postal_code": "385620247",
            "telephone_number": "931-268-3224",
            "fax_number": "931-268-3228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3698 S GRUNDY QUARLES HWY",
            "city": "GAINESBORO",
            "state": "TN",
            "postal_code": "385625950",
            "telephone_number": "931-268-3224",
            "fax_number": "931-268-3228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYCUS",
        "first_name": "DOUGLAS",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD020847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3057264",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BSTN",
            "identifier": "142892",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesboro, TN

Sources for this page

Verify at the official NPI Registry.