NPI age
14 years
Enumerated 2011-09-27
● Active
Type 1 · Individual
Dean William Rodemack, PA-C
Rodemack is 1 of 1 physician assistant providers in Fairfield and 1 of 1263 in Idaho.
Primary specialty
Physician Assistant
Plus 1 subspecialty
Licensed in
ID, WA
2 states
Status
Active
No deactivations on record
Last NPPES update
2021-04-08
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 1263 active physician assistant providers in Idaho.
NPI age
14 years
↑ 5 yr above median (9 yr)
State licenses
2 states
Top 81% — 19% of peers are multi-state
Subspecialties
1
In the 35% of peers with subspecialties
NPI lifetime · 2011 → 2026
2011-09Enumerated in NPPES
2011
2026
Where they practice
Practice location
401 W Camas Ave
Fairfield, ID 83327
Mailing address
794 Eastland Dr
Twin Falls, ID 833016856
Specialties
-
Physician Assistant PrimaryA 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...
-
Physician AssistantDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (WA) | 158543424 | |
| 01 (WA) | 0285610 | LABOR & INDUSTRIES |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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Request a quote →How to verify this provider
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.