Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Theresa Macdissi, PA-C

Individual provider Medical Physician Assistant · NPI 1164840617

Theresa Macdissi, PA-C is a Physician Assistant in Council Bluffs, Iowa. Qualified in 2013, 13 years ago. Licensed in Iowa and Nebraska.

Years since qualifying
13
Licensed in
IA, NE
In the registry since
2014
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1 Edmundson Pl Ste 306
Council Bluffs, IA 51503
Phone: (712) 396-7787
Fax: (712) 396-4115
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 092083 (IA)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 1802 (NE)

Record details

NPI number1164840617
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedApril 2, 2014
Last updated in NPPESJune 18, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Accepts Medicare assignment Not indicated

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