Individual provider Active NPI

Andrea Dockry, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Dayton, OH
National Provider Identifier
1861924490
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
35.139900 Issued in OH
Practice address
30 E Apple St Ste L200
Dayton, OH 45409-2939
Phone
(937) 208-2020
NPI assigned
Apr 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physical Medicine & Rehabilitation Physician 208100000X 35.139900 OH Primary
Physical Medicine & Rehabilitation Physician 208100000X 036.155922 IL

Addresses

Primary practice location

30 E Apple St Ste L200
Dayton, OH 45409-2939

Mailing address

29373 Network PL
Chicago, IL 60673-1293

Other practice location 1

3595 Olentangy River Rd
Columbus, OH 43214-3440
Phone (614) 566-5456

Other practice location 2

410 W 10th Ave
Columbus, OH 43210-1240
Phone (614) 293-8000

Other practice location 3

4400 W 95th St Ste 306
Oak Lawn, IL 60453-2659
Phone (708) 684-3170

Other identifiers 1

IdentifierTypeStateIssuer
036-155922OtherILLICENSE

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epichfir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address adockry310871@direct.myadvocateaurora.org Direct
Direct Messaging Address aedockry@premierhealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20230905002561 OH Practitioner - Physical Medicine and Rehabilitation 0446593131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Northeastern Ohio University College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Premier Health Specialists IncGroup PAC ID 5597708594, 576 clinicians

Practice addresses (Care Compare)

30 E Apple St
L200
Dayton, OH 45409-2939
Phone (937) 208-2020

Hospital & facility affiliations

  • Miami Valley Hospital Hospital, Dayton, OH, CCN 360051

Merit-based Incentive Payment System (MIPS)

Final score
81.38 of 100Reported as group
Quality
66.25
Promoting interoperability
100
Improvement activities
40
Cost
71.69

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.155922ILMDPhysical Medicine & Rehabilitation Physician
35.139900OHMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Specialists Inc CurrentSince Aug 14, 2023 Accepting new patients
Premier Health Specialists Inc CurrentSince Aug 14, 2023 Accepting new patients
Premier Heart Associates, Inc Past Accepting new patients

Locations

30 E Apple St
#L200
Dayton, OH 45409
Phone (937) 208-2020

30 E Apple St
#6258
Dayton, OH 45409
Phone (937) 208-5300

200 Medical Center Dr
Ste 375
Middletown, OH 45005
Phone (513) 420-3773

3170 Kettering Blvd
Bldg 2
Moraine, OH 45439

450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773

Interoperability endpoints

  • Direct secure messaging: andrea.dockry.1@19222.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1491091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1861924490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 E APPLE ST STE L200",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092939",
            "telephone_number": "937-208-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3595 Olentangy River Rd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432143440",
            "country_code": "US",
            "telephone_number": "614-566-5456",
            "fax_number": "614-566-6902",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "410 W 10th Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432101240",
            "country_code": "US",
            "telephone_number": "614-293-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4400 W 95th St Ste 306",
            "address_purpose": "LOCATION",
            "city": "Oak Lawn",
            "state": "IL",
            "postal_code": "604532659",
            "country_code": "US",
            "telephone_number": "708-684-3170",
            "fax_number": "708-684-2079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOCKRY",
        "first_name": "ANDREA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-02",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OH",
            "license": "35.139900",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "036.155922",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "036-155922",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epichfir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4400 W 95th St Ste 306",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604532659",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adockry310871@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4400 W 95th St Ste 306",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604532659",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aedockry@premierhealth.com",
            "affiliation": "N",
            "endpointDescription": "Premier email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "30 E Apple St Ste L200",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454092939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.