Dale Raymond Westrom, M.D., PH.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

G46342 Issued in CA

Practice address

990 Sonoma Ave Ste 2
Santa Rosa, CA 95404-4813

Phone

(707) 579-4239

Fax

(707) 579-0459

NPI assigned

Jul 11, 2006

Sex

Male

Sole proprietor

No

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.

• Integrated Dermatology of Santa Rosa, PC

  • Dermatology Physician
  • Santa Rosa, CA
  • NPI 1508441247

  CA, Dermatology

  Medicare reassignment Care Compare group NPD
• County of Tillamook

  • Federally Qualified Health Center (FQHC)
  • Tillamook, OR
  • NPI 1528151362

  OR

  Medicare reassignment NPD (past)

Specialty

Dermatology

Education

George Washington University School of Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integrated Dermatology of Santa Rosa PC 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

83.33 of 100Reported as group

Quality

66.67

Improvement activities

40

Procedures performed for Medicare patients

Medicare fee-for-service enrollment

Enrolled in CA, OR2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 17, 2008.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213660800000",
    "number": "1922032077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 SONOMA AVE STE 2",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044813",
            "telephone_number": "707-579-4239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 SONOMA AVE STE 2",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044813",
            "telephone_number": "707-579-4239",
            "fax_number": "707-579-0459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTROM",
        "first_name": "DALE",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2008-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G46342",
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "CA",
            "license": "G46242",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "G46342",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G46342",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Western Dental Services, Inc.
• Western Dental Services, Inc.
• Cody Corin Westfall, AMFT
• John Andrew Westhafer, PT
• Norman Paul Westhoff, M.D.
• Judy Marie Wetch
• Angela Merrisa Wetmore, PA-C
• Dustin K Wetmore, PA-C
• Nicole Wettach-Farias
• WHBC Midwives, Inc., a Nursing Corporation

• All providers in Santa Rosa, CA
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; 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.