Individual provider Active NPI

Dylan William Cortese, BS, MSPAS, PA-C

  • Physician Assistant
  • Clemmons, NC
National Provider Identifier
1942164512
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-15663 Issued in NC
Practice address
2770 Lewisville Clemmons Rd
Clemmons, NC 27012-8716
Phone
(336) 766-0324
NPI assigned
Dec 9, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 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 0010-15663 NC Primary

Addresses

Primary practice location

2770 Lewisville Clemmons Rd
Clemmons, NC 27012-8716

Mailing address

2077 Rossmore Rd
Clemmons, NC 27012-7911
Phone (336) 406-5643

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20260223003136 NC Practitioner - Physician Assistant 6901387497 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic Diagnostic of North Carolina PCGroup PAC ID 6002837572, 208 clinicians

Practice addresses (Care Compare)

2770 Lewisville Clemmons Rd
Clemmons, NC 27012-8716
Phone (866) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-15663NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Primary Care North Carolina PLLC Physician Assistant CurrentSince Jan 27, 2026 Accepting new patients
Minuteclinic Diagnostic of North Carolina PC Physician Assistant CurrentSince Jan 27, 2026 Accepting new patients

Locations

10100 S Main St
Archdale, NC 27263
Phone (336) 431-0715

2770 Lewisville Clemmons Rd
Clemmons, NC 27012
Phone (336) 712-0663

6840 Glenwood Ave
Raleigh, NC 27612
Phone (401) 770-4415

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": "1765238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765324800000",
    "number": "1942164512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2077 ROSSMORE RD",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270127911",
            "telephone_number": "336-406-5643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2770 LEWISVILLE CLEMMONS RD",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128716",
            "telephone_number": "336-766-0324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORTESE",
        "first_name": "DYLAN",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "BS, MSPAS, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-12-09",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-15663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clemmons, NC

Sources for this page

Verify at the official NPI Registry.