Monica M Dimagno, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301065992 Issued in MI

Practice address

2211 Old Earhart Rd Ste 195
Ann Arbor, MI 48105-2963

Phone

(734) 615-9200

Fax

(734) 615-9205

NPI assigned

Oct 11, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2018 through Jul 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Clarkston Lakes Family Medicine LLC

  • Family Medicine Physician
  • Clarkston, MI
  • NPI 1457359267
  NPD (past)

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1063501930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "585 SOUTH BLVD E STE 100",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483413163",
            "telephone_number": "248-206-1200",
            "fax_number": "734-615-9505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 OLD EARHART RD STE 195",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481052963",
            "telephone_number": "734-615-9200",
            "fax_number": "734-615-9205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMAGNO",
        "first_name": "MONICA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301065992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3469117",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia M Dillon, LPN
• Lauren Michelle Dillon, PTA
• Veronica Ichikawa Dillon
• Alexander Thomas Dils
• Michaelle Dimaggio-Potter
• Eleni Vasilios Dimaraki, MD
• Kimberly Lambart Dimaria, NP
• Derek E Dimcheff, MD
• Colin Diment
• Anastasia Petro Dimick, M.D.

• Internal Medicine Physician in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.