Marc E. Dicklin, P.A. -C
NPI 1205837408ActiveIndividual· Physician Assistant· Avon, CO
Physician Assistant (P.A. -C) with Summit Memorial Medical Group LLC, practicing in Avon, Colorado. Enrolled in Medicare as practitioner - physician assistant.
Overview
| NPI | 1205837408 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | P.A. -C |
| Sole proprietor | No |
| NPI issued | Aug 10, 2005 |
| Last updated in NPPES | Oct 19, 2026 |
| Certified by provider | Oct 19, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | PA.0001152 | CO |
| Physician Assistant | 363A00000X | 001351 | IA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (WY) |
|---|
Education and affiliations
| Graduation year | 1999 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical group
- Summit Memorial Medical Group LLCCasper, WY · 39 clinicians
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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