TODD BRYAN DYKSTRA (NPI# 1154373983) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154373983 |
| Entity Type | Individual |
| Full Name | TODD BRYAN DYKSTRA |
| Credential | PA |
| Practice Address |
3757 Carman Rd Suite 100 Schenectady NY 12303-5438 |
| Mailing Address |
711 Troy Schenectady Rd Ste 203 Latham NY 12110-2461 |
| Practice Telephone | 5183557063 |
| Practice Fax Number | 5183570646 |
| Mailing Telephone | 5187823700 |
| Mailing Fax Number | 5187823799 |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2018-01-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 009787-1 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
001382 | IA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02970441 | 05 | |
| NY | FIDELIS | 101220000005 | 01 |
| Street Address |
3757 CARMAN RD SUITE 100 |
| City | SCHENECTADY |
| State | NY |
| Zip Code | 12303-5438 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548262991 | Nasrene R Yadegari-lewis | Internal Medicine | 3757 Carman Rd, Suite 100, Schenectady, NY 12303 | 2005-08-15 |
| 1801350020 | Kysa Berg | Physical Therapist | 3757 Carman Rd, Schenectady, NY 12303-5442 | 2019-01-23 |
| 1366906513 | Janet Hakey-brusgul | Physical Therapist | 3757 Carman Rd, Schenectady, NY 12303-5442 | 2019-01-22 |
| 1619441839 | Brianna Piel | Physical Therapist | 3757 Carman Rd, Schenectady, NY 12303-5442 | 2019-01-22 |
| 1447723093 | Sharon Marion | Physical Therapist | 3757 Carman Rd, Schenectady, NY 12303-5442 | 2019-01-07 |
| 1902189277 | Community Care Physicians, PC | Internal Medicine | 3757 Carman Rd, Suite 103, Schenectady, NY 12303-5438 | 2011-09-23 |
| 1699056317 | Community Care Physicians, PC | Family Medicine | 3757 Carman Rd, Schenectady, NY 12303 | 2011-09-08 |
| 1376854646 | Cary Vachon | Family Medicine | 3757 Carman Rd, Suite 100, Schenectady, NY 12303-5438 | 2010-07-01 |
| 1316166317 | Robbie L Hoyt | Physical Therapist | 3757 Carman Rd, Schenectady, NY 12303-5442 | 2007-04-25 |
| 1104934546 | Brad M Denovio | Physician Assistant | 3757 Carman Rd, Suite 100, Schenectady, NY 12303-5438 | 2006-08-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356991608 | Eunice Matias | Technician | 7036 Suzanne Lane, Schenectady, NY 12303 | 2019-09-18 |
| 1497280176 | Krystal Varrenti | Registered Nurse | 3437 Carman Road, Pine Bush Elementary School, Schenectady, NY 12303 | 2017-05-01 |
| 1801291943 | Michelle Anne Durling | Registered Nurse | 2057 Rensselare Ave, Schenectady, NY 12303 | 2014-10-31 |
| 1447691068 | Dametress Maryland Haughton | Licensed Practical Nurse | 2303 2nd Avenue, Rotterdam, NY 12303 | 2013-07-11 |
| 1669721841 | Michelle L Hall, Od, Pllc | Optometrist | 3770 Carman Road, #6b, Schenectady, NY 12303 | 2012-09-05 |
| 1851640403 | Christina Marie Pustay | Specialist | 3437 Carman Rd., Schenectady, NY 12303 | 2012-08-29 |
| 1598048332 | Alicia Backus | Social Worker | 108 Education Drive, Schenectady, NY 12303 | 2011-09-27 |
| 1922321611 | Leanne C Williams | Pharmacist | 1630 Chrisler Avenue, Schenectady, NY 12303 | 2010-03-09 |
| 1942487814 | William J Dawson | Pharmacist | 1350 Altamont Ave, Schenectady, NY 12303 | 2008-01-23 |
| 1598958845 | Alan Beck | Pharmacist | 1400 Altamount Ave, Schenectady, NY 12303 | 2007-08-21 |
| Find all providers in zip 12303 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164957072 | Samantha Anne Relyea | Physician Assistant | 1101 Nott St # B5, Schenectady, NY 12308-2425 | 2017-04-28 |
| 1487939872 | Christopher J Bertino | Physician Assistant | 1 River Rd Bldg 43, Schenectady, NY 12345-8309 | 2011-10-17 |
| 1932411451 | Tracey E Zusman | Physician Assistant | 1101 Nott St., Schenectady, NC 12308 | 2010-07-13 |
| 1578679338 | Karen A Mcgarry | Physician Assistant | 3757 Carman Rd., Suite 100, Schenectady, NY 12303 | 2006-08-22 |
| 1780626531 | Richard A Butz | Physician Assistant | 1322 Gerling St, Schenectady, NY 12308-1702 | 2006-06-12 |
| 1124022611 | Joseph A Petrosino | Physician Assistant | 2125 River Rd Ste 303, Schenectady, NY 12309-1135 | 2005-06-13 |
| 1356958896 | Kristen Lee Hebert | Physician Assistant | 1667 Elizabeth St, Schenectady, NY 12303-3805 | 2020-09-29 |
| 1285246488 | Perri Clifford | Physician Assistant | 2125 River Rd Ste 303b, Schenectady, NY 12309-1136 | 2020-08-19 |
| 1750927158 | Robert Akey | Physician Assistant | 2125 River Rd Ste 203, Schenectady, NY 12309-1135 | 2019-11-20 |
| 1861034969 | Mallory Macdonald | Physician Assistant | 1400 Altamont Ave, Schenectady, NY 12303-2909 | 2019-10-10 |
| Find all providers in SCHENECTADY | ||||
| City | SCHENECTADY |
| Zip Code | 12303 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.