NPIMap

Individual provider Active NPI

Douglas Matthew Iddings, DO

  • Surgical Oncology Physician
  • Flint, MI
National Provider Identifier
1023233384
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
5101014246 Issued in MI
Practice address
302 Kensington Ave
Flint, MI 48503-2044
Phone
(810) 762-8092
Fax
(810) 762-8892
NPI assigned
Apr 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Oncology Physician 2086X0206X 5101014246 MI Primary

Addresses

Primary practice location

302 Kensington Ave
Flint, MI 48503-2044

Mailing address

302 Kensington Ave
Flint, MI 48503-2044
Phone (810) 762-8092

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address diddings37090@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041210000820 MI Practitioner - General Surgery 4587621586 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Michigan State University College of Osteopathic Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1975 W M 21
Suite 103
Owosso, MI 48867-8164

302 Kensington Ave
Flint, MI 48503-2044

302 Kensington Ave
Flint, MI 48503-5993

333 N Summit St FL
Suite 7
Toledo, OH 43604-1531

894 Campus Dr B
Hancock, MI 49930-1571

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy11
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue19
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Monroe Physicians CurrentSince Feb 1, 2023 Accepting new patients
Portage Physician Practices Inc CurrentSince Jul 7, 2018 Accepting new patients
Hurley Medical Center Surgery CurrentSince Dec 15, 2013 Accepting new patients
Portage Physician Practices Inc CurrentSince Jul 7, 2018 Accepting new patients
Hurley Medical Center CurrentSince Dec 15, 2013 Accepting new patients
Hurley Medical Center Current Accepting new patients
Oncology Institute Medical Group Surgical Oncology Past Accepting new patients
Mercy Memorial Hospital Corporatio Past Accepting new patients

Locations

302 Kensington Ave
Flint, MI 48503
Phone (810) 762-8058

2 Hurley Plz
Ste 109
Flint, MI 48503
Phone (810) 262-7300

1 Hurley Plz
Flint, MI 48503
Phone (810) 257-9000

8384 Holly Rd
Ste 1
Grand Blanc, MI 48439
Phone (810) 606-7888

500 Campus Dr
Ste 5
Hancock, MI 49930
Phone (906) 483-1700

500 Campus Dr
Hancock, MI 49930
Phone (906) 483-1000

3175 Smith Rd
Lambertville, MI 48144
Phone (734) 856-5494

730 N Macomb St
Ste 329
Monroe, MI 48162
Phone (734) 240-5860

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

Interoperability endpoints

  • Direct secure messaging: diddings17037@direct.hurleymc.com

Organizations & group practices 8

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1023233384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 KENSINGTON AVE",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485032044",
            "telephone_number": "810-762-8092",
            "fax_number": "810-762-8892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 KENSINGTON AVE",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485032044",
            "telephone_number": "810-762-8092",
            "fax_number": "810-762-8892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDDINGS",
        "first_name": "DOUGLAS",
        "middle_name": "MATTHEW",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "MI",
            "license": "5101014246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "diddings37090@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.