Individual provider Active NPI

Derek Dillon, D.O.

  • Family Medicine Physician
  • Dunedin, FL
National Provider Identifier
1023491222
Registry record updated Mar 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS14453 Issued in FL
Practice address
180 Patricia Ave
Dunedin, FL 34698-8103
Phone
(727) 733-4193
Fax
(813) 635-2638
NPI assigned
Jul 7, 2015
Last updated
Mar 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS14453 FL Primary

Addresses

Primary practice location

180 Patricia Ave
Dunedin, FL 34698-8103

Mailing address

180 Patricia Ave
Dunedin, FL 34698-8103
Phone (727) 733-4193

Other identifiers 1

IdentifierTypeStateIssuer
021862000MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Derek.DillonDO@direct.mybaycare.org Health Information Exchange (HIE) BayCare Medical Group, Inc.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170929003169 FL Practitioner - Family Practice 8527333517 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians

Practice addresses (Care Compare)

180 Patricia Ave
Dunedin, FL 34698-8103
Phone (727) 733-4193

2461 Enterprise Rd
Suite C
Clearwater, FL 33763-1726
Phone (727) 725-5060

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS14453FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. Family Medicine CurrentSince Jul 29, 2018 Accepting new patients
Baycare Medical Group, Inc. Family Medicine CurrentSince Jul 29, 2018 Accepting new patients

Locations

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 281-9390

1022 Main St
Ste M
Dunedin, FL 34698
Phone (727) 210-2225

180 Patricia Ave
Dunedin, FL 34698
Phone (727) 733-4193

180 Patricia Ave
Ste Pcp
Dunedin, FL 34698

Interoperability endpoints

  • Direct secure messaging: derek.dillondo@direct.mybaycare.org

Organizations & group practices 2

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

Hospital & facility affiliations 6

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": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1023491222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 PATRICIA AVE",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346988103",
            "telephone_number": "727-733-4193",
            "fax_number": "813-635-2638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 PATRICIA AVE",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346988103",
            "telephone_number": "727-733-4193",
            "fax_number": "813-635-2638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLON",
        "first_name": "DEREK",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-07",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS14453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021862000",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Derek.DillonDO@direct.mybaycare.org",
            "affiliation": "Y",
            "affiliationName": "BayCare Medical Group, Inc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2995 Drew St Fl 2",
            "city": "Clearwater",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337593012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dunedin, FL

Sources for this page

Verify at the official NPI Registry.