Individual provider Active NPI

Sandra B Cadichon, MD

  • Neonatal-Perinatal Medicine Physician
  • Ypsilanti, MI
National Provider Identifier
1003869017
Registry record updated Dec 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
4301505415 Issued in MI
Practice address
5301 McAuley Dr
Ypsilanti, MI 48197-1051
Phone
(734) 712-3327
Fax
(734) 712-5525
NPI assigned
May 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 036100288 IL
Neonatal-Perinatal Medicine Physician 2080N0001X 35.098791 OH
Neonatal-Perinatal Medicine Physician 2080N0001X 4301505415 MI Primary

Addresses

Primary practice location

5301 McAuley Dr
Ypsilanti, MI 48197-1051

Mailing address

24 Frank Lloyd Wright Dr Ste J2000
Ann Arbor, MI 48105-9484
Phone (734) 747-6766

Other identifiers 5

IdentifierTypeStateIssuer
10003869017MedicaidMI
7010002OtherAETNA
036100288MedicaidIL
0063558MedicaidOH
10256OtherOHPARAMOUNT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221219002288 MI Practitioner - Pediatric Medicine 2860489457 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036100288ILMDNeonatal-Perinatal Medicine Physician
35.098791OHMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph Mercy Hospital CurrentSince Dec 6, 2022 Accepting new patients
St Joseph Mercy Hospital CurrentSince Dec 6, 2022 Accepting new patients
St Joseph Mercy Hospital Current Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

20555 Victor Pkwy
Livonia, MI 48152
Phone (734) 343-3925

5301 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-7246

Interoperability endpoints

  • Direct secure messaging: scadichon1576978@direct.trinity-health.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640304000000",
    "number": "1003869017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR STE J2000",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-747-6766",
            "fax_number": "734-222-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 MCAULEY DR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971051",
            "telephone_number": "734-712-3327",
            "fax_number": "734-712-5525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CADICHON",
        "first_name": "SANDRA",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2021-12-24",
        "certification_date": "2021-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "IL",
            "license": "036100288",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "OH",
            "license": "35.098791",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "MI",
            "license": "4301505415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10003869017",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7010002",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036100288",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0063558",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARAMOUNT",
            "identifier": "10256",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.