Individual provider Active NPI

Michael F Ditillo, DO

  • Surgical Critical Care Physician
  • Pittsburgh, PA
National Provider Identifier
1063672194
Registry record updated May 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
OS017021 Issued in PA
Practice address
320 E North Ave FL 5
Pittsburgh, PA 15212-4756
Phone
(412) 359-6466
Fax
(412) 359-8639
NPI assigned
Jun 12, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X OS017021 PA Primary

Addresses

Primary practice location

320 E North Ave FL 5
Pittsburgh, PA 15212-4756

Mailing address

320 E North Ave FL 5
Pittsburgh, PA 15212-4756
Phone (412) 359-6466

Other identifiers 1

IdentifierTypeStateIssuer
102911435MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20190701001342 AZ Practitioner - General Surgery 3870648637 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
New York College of Osteo Medicine of New York Institute of Technology, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner-University Medical GroupGroup PAC ID 7719899871, 1,066 clinicians

Practice addresses (Care Compare)

3838 N Campbell Ave
BLDG 1
Tucson, AZ 85719-1454
Phone (520) 694-2873

Merit-based Incentive Payment System (MIPS)

Final score
93.34 of 100Reported as apm
Quality
74.56
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS017021PAMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner-University Medical Group Family Medicine CurrentSince Jun 1, 2019 Accepting new patients
Banner-University Medical Group CurrentSince Jun 1, 2019 Accepting new patients

Locations

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

3838 N Campbell Ave
Bldg 2
Tucson, AZ 85719

3838 N Campbell Ave
Bldg 1
Tucson, AZ 85719
Phone (520) 694-2873

535 N Wilmot Rd
Ste 101
Tucson, AZ 85711
Phone (520) 694-9988

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493596800000",
    "number": "1063672194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 E NORTH AVE FL 5",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152124756",
            "telephone_number": "412-359-6466",
            "fax_number": "412-359-8639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 E NORTH AVE FL 5",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152124756",
            "telephone_number": "412-359-6466",
            "fax_number": "412-359-8639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITILLO",
        "first_name": "MICHAEL",
        "middle_name": "F",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-12",
        "last_updated": "2017-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "PA",
            "license": "OS017021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102911435",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.