Individual provider Active NPI

Michael Dillon, M.D.

  • Emergency Medicine Physician
  • Oakland, CA
National Provider Identifier
1063436111
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G35028 Issued in CA
Practice address
2107 Livingston St
Suite a
Oakland, CA 94606-5218
Phone
(510) 436-9000
Fax
(510) 436-9013
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G35028 CA Primary

Addresses

Primary practice location

2107 Livingston St
Suite a
Oakland, CA 94606-5218

Mailing address

2107 Livingston St
Suite a
Oakland, CA 94606-5218
Phone (510) 436-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NV2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20081227000001 CA Practitioner - Emergency MedicinePractitioner - Family Practice 4183533003 Reassigns benefits to 1 organization
I20220421000510 NV Practitioner - Emergency Medicine 4183533003 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Lyon Health Center, Inc. Current Accepting new patients
South Lyon Health Center, Inc. CurrentSince Feb 27, 2022 Accepting new patients
South Lyon Health Center, Inc. CurrentSince Feb 27, 2022 Accepting new patients
South Lyon Health Center, Inc. Current Accepting new patients
Fairchild Medical Group Past Accepting new patients

Locations

213 S Whitacre St
Yerington, NV 89447
Phone (775) 463-2301

Organizations & group practices 6

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063436111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2107 LIVINGSTON ST",
            "address_2": "SUITE A",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946065218",
            "telephone_number": "510-436-9000",
            "fax_number": "510-436-9013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2107 LIVINGSTON ST",
            "address_2": "SUITE A",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946065218",
            "telephone_number": "510-436-9000",
            "fax_number": "510-436-9013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLON",
        "first_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G35028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.