Theresa Ann Dwyer

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA55969 Issued in CA

Practice address

2335 E Kashian LN Ste 240
Fresno, CA 93701-2211

Phone

(559) 320-0545

Fax

(559) 320-0550

NPI assigned

Sep 13, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mid-Columbia Medical CenterGroup PAC ID 3779487251, 99 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mid-Columbia Medical Center Hospital, The Dalles, OR, CCN 380001
• Klickitat Valley Hospital Hospital, Goldendale, WA, CCN 501316
• Skyline Hospital Hospital, White Salmon, WA, CCN 501315

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tdwyer119494@direct.ohsu.edu

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.

• Mid-Columbia Medical Center

  • General Practice Physician
  • The Dalles, OR
  • NPI 1053409599

  OR

  Medicare reassignment Care Compare group NPD
• Mid-Columbia Medical Center

  • Rural Health Clinic/Center
  • The Dalles, OR
  • NPI 1154351336
  Care Compare group NPD (past)
• Mid-Columbia Medical Center

  • Rural Health Clinic/Center
  • The Dalles, OR
  • NPI 1407887052
  Care Compare group NPD (past)
• Mid-Columbia Medical Center

  • Home Health Agency
  • The Dalles, OR
  • NPI 1205804101
  Care Compare group
• Mid-Columbia Medical Center

  • Critical Access Hospital Clinic/Center
  • The Dalles, OR
  • NPI 1306842752
  Care Compare group
• Mid-Columbia Medical Center

  • Rural Health Clinic/Center
  • The Dalles, OR
  • NPI 1871833772
  Care Compare group
• Healthcare for the Mid-Columbia Region

  • Emergency Medicine Physician
  • The Dalles, OR
  • NPI 1497797856
  NPD
• Mid-Columbia Medical Center

  • Multi-Specialty Clinic/Center
  • Hood River, OR
  • NPI 1568979680
  NPD
• Mid-Columbia Medical Center

  • Multi-Specialty Clinic/Center
  • The Dalles, OR
  • NPI 1992094817
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Klickitat County Public Hospital District No 1

  • Critical Access Hospital
  • Goldendale, WA
  • NPI 1386689487

  Hospital

  Care Compare affiliation
• Mid-Columbia Medical Center

  • Critical Access Hospital Clinic/Center
  • The Dalles, OR
  • NPI 1306842752

  Hospital

  Care Compare affiliation
• Public Hospital District No. 2, Klickitat County, Washington

  • Critical Access Hospital
  • White Salmon, WA
  • NPI 1760455687

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1536796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574467200000",
    "number": "1982187100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 E 19TH ST",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583317",
            "telephone_number": "559-443-2682",
            "fax_number": "559-443-2681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2335 E KASHIAN LN STE 240",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937012211",
            "telephone_number": "559-320-0545",
            "fax_number": "559-320-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DWYER",
        "first_name": "THERESA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-13",
        "last_updated": "2019-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA55969",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA55969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Cole Dyar
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• All providers in Fresno, CA
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2019; 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.