Individual provider Active NPI

Fatima Janeth Dealy, PA-C

  • Physician Assistant
  • Stayton, OR
National Provider Identifier
1891068169
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA157447 Issued in OR
Practice address
1401 N 10TH Ave Ste 100
Stayton, OR 97383-1486
Phone
(503) 769-2175
Fax
(503) 769-5877
NPI assigned
Feb 17, 2012
Last updated
Jan 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA157447 OR Primary

Addresses

Primary practice location

1401 N 10TH Ave Ste 100
Stayton, OR 97383-1486

Mailing address

PO Box 577
Stayton, OR 97383-0577
Phone (503) 769-2175

Other identifiers 1

IdentifierTypeStateIssuer
500644586MedicaidOR

Other names 1

  • Fatima Janeth Baar Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120508000628 OR Practitioner - Physician Assistant 6901068949 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Santiam Memorial HospitalGroup PAC ID 6103729751, 128 clinicians

Practice addresses (Care Compare)

1401 N 10TH Ave
Suite 100
Stayton, OR 97383-1486
Phone (503) 769-6386

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Santiam Memorial Hospital CurrentSince Feb 5, 2018 Accepting new patients
Santiam Memorial Hospital CurrentSince Feb 5, 2018 Accepting new patients
Santiam Memorial Hospital Past Accepting new patients

Locations

1375 N 10th Ave
Ste B
Stayton, OR 97383
Phone (503) 769-7546

1401 N 10th Ave
Ste 100
Stayton, OR 97383
Phone (503) 769-6386

Interoperability endpoints

  • Direct secure messaging: fbaar@santiam.securechart.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1329436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1891068169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 577",
            "city": "STAYTON",
            "state": "OR",
            "postal_code": "973830577",
            "telephone_number": "503-769-2175",
            "fax_number": "503-769-3472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 N 10TH AVE STE 100",
            "city": "STAYTON",
            "state": "OR",
            "postal_code": "973831486",
            "telephone_number": "503-769-2175",
            "fax_number": "503-769-5877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEALY",
        "first_name": "FATIMA",
        "middle_name": "JANETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-17",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA157447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500644586",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FATIMA",
            "last_name": "BAAR",
            "middle_name": "JANETH",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Stayton, OR

Sources for this page

Verify at the official NPI Registry.