Individual provider Active NPI

Patricia Marie Dykema, PA

  • Physician Assistant
  • Savannah, GA
National Provider Identifier
1932127149
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4589 Issued in GA
Practice address
5353 Reynolds St Ste 107
Savannah, GA 31405-6089
Phone
(912) 819-7630
Fax
(912) 819-5860
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4589 GA Primary
Physician Assistant 363A00000X TL3290 SC

Addresses

Primary practice location

5353 Reynolds St Ste 107
Savannah, GA 31405-6089

Mailing address

PO Box 11407 Dept #1622
Birmingham, AL 35246-1622
Phone (912) 819-8427

Other practice location 1

225 Candler Dr Ste 100
Savannah, GA 31405-6093
Phone (912) 352-1700

Other identifiers 1

IdentifierTypeStateIssuer
257354264AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20051007000184 GA Practitioner - Physician Assistant 2163447335 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SJC Oncology Services - Georgia, LLCGroup PAC ID 8426086901, 26 clinicians

Practice addresses (Care Compare)

225 Candler Dr
Suite 100
Savannah, GA 31405-6023

225 Candler Dr
Suite 100
Savannah, GA 31405-6093
Phone (912) 352-1700

5353 Reynolds St
Savannah, GA 31405-6015

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
67.69 of 100Reported as group
Quality
63.94
Promoting interoperability
63
Improvement activities
40
Cost
59.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3290SCMDOral and Maxillofacial Surgery (Dentist)
4589GAMDPhysician Assistant
TL3290SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dekalb Medical Specialty Care Group LLC Past Accepting new patients
Atlanta Cardiac & Thoracic Surgery Past Accepting new patients

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1932127149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11407 DEPT #1622",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352461622",
            "telephone_number": "912-819-8427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5353 REYNOLDS ST STE 107",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314056089",
            "telephone_number": "912-819-7630",
            "fax_number": "912-819-5860"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 Candler Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314056093",
            "country_code": "US",
            "telephone_number": "912-352-1700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DYKEMA",
        "first_name": "PATRICIA",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "4589",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "TL3290",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "257354264A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.