Individual provider Active NPI

Dalton Thomas Whaley, PA-C

  • Physician Assistant
  • Cooperstown, NY
National Provider Identifier
1922665660
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
023791 Issued in NY
Practice address
1 Atwell Rd
Cooperstown, NY 13326-1394
Phone
(607) 547-3456
NPI assigned
May 28, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 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 023791 NY Primary

Addresses

Primary practice location

1 Atwell Rd
Cooperstown, NY 13326-1394

Mailing address

351 Bissell Rd
Fly Creek, NY 13337-2109
Phone (518) 955-0752

Other practice location 1

21 Homer Folks
Oneonta, NY 13820-1394
Phone (607) 433-2111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20191010001910 NY Practitioner - Physician Assistant 9931430634 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Imogene Bassett HospitalGroup PAC ID 3779488325, 780 clinicians

Practice addresses (Care Compare)

178 Grandview Dr
Cobleskill, NY 12043-5144
Phone (518) 254-3456

321 E Albany St
Herkimer, NY 13350-2016
Phone (315) 867-2700

Greystone Commercial Park
4580 State Route 28
Milford, NY 13807-1147
Phone (607) 547-7646

Merit-based Incentive Payment System (MIPS)

Final score
92.62 of 100Reported as apm
Quality
77.97
Promoting interoperability
98
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
92.62 of 100Reported as apm
Quality
77.97
Promoting interoperability
98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
023791NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Imogene Bassett Hospital CurrentSince Sep 23, 2019 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Sep 23, 2019 Accepting new patients

Locations

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

321 E Albany St
Herkimer, NY 13350
Phone (315) 867-2700

1 Associate Dr
Oneonta, NY 13820
Phone (607) 433-6300

130 North St
Walton, NY 13856
Phone (607) 865-6541

Interoperability endpoints

  • Direct secure messaging: dwhaley335967@bassett.direct-ci.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1559001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1922665660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 BISSELL RD",
            "city": "FLY CREEK",
            "state": "NY",
            "postal_code": "133372109",
            "telephone_number": "518-955-0752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ATWELL RD",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133261394",
            "telephone_number": "607-547-3456"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 Homer Folks",
            "address_purpose": "LOCATION",
            "city": "Oneonta",
            "state": "NY",
            "postal_code": "138201394",
            "country_code": "US",
            "telephone_number": "607-433-2111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHALEY",
        "first_name": "DALTON",
        "middle_name": "THOMAS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-28",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "023791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cooperstown, NY

Sources for this page

Verify at the official NPI Registry.