Individual provider Active NPI

Terry DO

  • Physician Assistant
  • Dubuque, IA
National Provider Identifier
1902687437
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2000 University Ave
Dubuque, IA 52001-5050
Phone
(712) 577-4967
NPI assigned
Oct 10, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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 IA Primary

Addresses

Primary practice location

2000 University Ave
Dubuque, IA 52001-5050

Mailing address

2000 University Ave
Dubuque, IA 52001-5050
Phone (712) 577-4967

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20250320000560 IA Practitioner - Physician Assistant 5496277352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2720 Stone Park Blvd
Sioux City, IA 51104-3734
Phone (712) 279-3500

801 5TH St
Sioux City, IA 51101-1326

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Iowa Hospital Corporation CurrentSince Apr 1, 2025 Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients

Locations

2720 Stone Park Blvd
Sioux City, IA 51104
Phone (712) 259-3000

Interoperability endpoints

  • Direct secure messaging: tdo1180893@direct.unitypoint.org

Organizations & group practices 2

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": "1696896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1902687437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 UNIVERSITY AVE",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520015050",
            "telephone_number": "712-577-4967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 UNIVERSITY AVE",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520015050",
            "telephone_number": "712-577-4967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DO",
        "first_name": "TERRY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-10",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

Verify at the official NPI Registry.