Tad Palmer Dewald

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

ME162738 Issued in FL

Practice address

3683 S Miami Ave Ste 460
Miami, FL 33133-4238

Phone

(305) 459-3377

NPI assigned

Jun 4, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL, FL2 enrollments

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 2

Specialty

Physical Medicine and RehabilitationAlso: Sports Medicine

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Weston Medical Health Center LLCGroup PAC ID 6709935364, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Weston Medical Health Center, LLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Weston, FL
  • NPI 1245413194
  Medicare reassignment Care Compare group NPD
• STV Sports Medicine & Orthopedics LLC

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Birmingham, AL
  • NPI 1467818575
  Medicare reassignment NPD
• STV Sports Medicine & Orthopedics LLC

  • Durable Medical Equipment & Medical Supplies
  • Pelham, AL
  • NPI 1770365504
  NPD

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

{
    "created_epoch": "1338768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1811258130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3683 S MIAMI AVE STE 460",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331334238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3683 S MIAMI AVE STE 460",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331334238",
            "telephone_number": "305-459-3377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "805 Saint Vincents Dr",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352051636",
            "country_code": "US",
            "telephone_number": "245-939-3699",
            "fax_number": "205-581-7155",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5301 E Grant Rd",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857122805",
            "country_code": "US",
            "telephone_number": "520-784-6200",
            "fax_number": "520-784-6109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEWALD",
        "first_name": "TAD",
        "middle_name": "PALMER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-04",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "AL",
            "license": "MD.35418",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "AZ",
            "license": "54466",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "FL",
            "license": "ME162738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "279012",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Claudia Hope Devier, RNFA
• Carissa Devlin, PA-C
• Michelle Devlin, BCBA
• Aday Devora Delgado
• Kirstin Devries
• Afsana Dewan
• Neelesh Dewan, MD
• Dewhurst Medical Services Inc
• Deyris Correa Therapy LLC
• Deyris Correa Therapy LLC

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Miami, FL
• Providers in Miami, FL by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.