Bret A Dirks, MD

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

M6482 Issued in ID

Practice address

850 W Ironwood Dr Suite 300
Coeur Dalene, ID 83814

Phone

(208) 667-1376

Fax

(208) 292-0873

NPI assigned

Sep 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ID

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 1

Specialty

Neurosurgery

Education

University of Washington School of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Paragon Physical Therapy and Rehab LLCGroup PAC ID 4284902339, 87 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Inland Northwest Spine PLLC

  • Orthopaedic Surgery Physician
  • Coeur D Alene, ID
  • NPI 1700974714

  ID, Neurological Surgery

  Medicare reassignment NPD
• Paragon Physical Therapy and Rehab, LLC

  • Physical Therapy Clinic/Center
  • Bullhead City, AZ
  • NPI 1538694104
  Care Compare group

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204070400000",
    "number": "1962508366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 W IRONWOOD DR SUITE 300",
            "city": "COEUR DALENE",
            "state": "ID",
            "postal_code": "83814",
            "telephone_number": "208-667-1376",
            "fax_number": "208-292-0873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 W IRONWOOD DR SUITE 300",
            "city": "COEUR DALENE",
            "state": "ID",
            "postal_code": "83814",
            "telephone_number": "208-667-1376",
            "fax_number": "208-292-0873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIRKS",
        "first_name": "BRET",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2008-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "ID",
            "license": "M6482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2741300",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDC GROUP",
            "identifier": "1376455",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Albert Allen Crook, DO
• Cultivation, LLC
• Cultivation, LLC
• Jon A Cutting, M.D.
• Susan Marie Daugharty Fowler, MD
• Donald J Johnson DDS Inc
• Baily C. Donovan, DPT
• Catherine Dotolo
• Susan L Dummer, NP
• Erin Duncan, LMSW

• All providers in Coeur Dalene, ID
• Neurological Surgery Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.