Craig Dale, is a medicare enrolled "Physician Assistant" in Lakeside, Oregon. His current practice location is
441 N Tenmile Lk, Lakeside, Oregon. You can reach out to his office (for appointments etc.) via phone at
(719) 239-1403.
Craig Dale is licensed to practice in Idaho (license number PA1619) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1023496965.
Provider's Profile
Full Name | Craig Dale |
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Gender | Male |
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Speciality | Physician Assistant |
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Location | 441 N Tenmile Lk, Lakeside, Oregon |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1023496965
- Provider Enumeration Date: 05/12/2015
- Last Update Date: 02/17/2022
Medicare PECOS Information:
- PECOS PAC ID: 3476831041
- Enrollment ID: I20180913001357
Medical Identifiers
Medical identifiers for Craig Dale such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1023496965 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363A00000X | Physician Assistant | PA179589 (Oregon) | Secondary |
363A00000X | Physician Assistant | PA60843540 (Washington) | Secondary |
363A00000X | Physician Assistant | PA1619 (Idaho) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Craig Dale is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Craig Dale, 441 N Tenmile Lk, Lakeside, OR 97449-8648 Ph: (719) 239-1403 | Craig Dale, 441 N Tenmile Lk, Lakeside, OR 97449-8648 Ph: (719) 239-1403 |
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