Individual provider Active NPI

Dale R McCririe, DO

  • Surgery Physician
  • Hillsdale, MI
National Provider Identifier
1104835131
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
DM010091 Issued in MI
Practice address
451 Hidden Meadows Dr
Ste 260
Hillsdale, MI 49242
Phone
(517) 437-5350
Fax
(517) 437-8328
NPI assigned
Aug 7, 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
Surgery Physician 208600000X DM010091 MI Primary

Addresses

Primary practice location

451 Hidden Meadows Dr
Ste 260
Hillsdale, MI 49242

Mailing address

451 Hidden Meadows Dr
Ste 260
Hillsdale, MI 49242
Phone (517) 437-5350

Other identifiers 1

IdentifierTypeStateIssuer
2893503MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20100915000150 MI Practitioner - General Surgery 6406971431 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DM010091MIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hillsdale Community Health Center Surgery CurrentSince Aug 1, 2012 Accepting new patients

Locations

451 Hidden Meadows Dr
Ste 260
Hillsdale, MI 49242
Phone (269) 969-6196

168 S Howell St
Hillsdale, MI 49242
Phone (517) 437-4451

451 Hidden Meadows Dr
Hillsdale, MI 49242
Phone (517) 437-0010

Interoperability endpoints

  • Direct secure messaging: dmccririe114975@direct.parkviewexchange.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hillsdale HospitalHillsdale, MI, CCN 230037 Hospital Corporate Director Nov 9, 2010

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 1

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": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104835131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 HIDDEN MEADOWS DR",
            "address_2": "STE 260",
            "city": "HILLSDALE",
            "state": "MI",
            "postal_code": "49242",
            "telephone_number": "517-437-5350",
            "fax_number": "517-437-8328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 HIDDEN MEADOWS DR",
            "address_2": "STE 260",
            "city": "HILLSDALE",
            "state": "MI",
            "postal_code": "49242",
            "telephone_number": "517-437-5350",
            "fax_number": "517-437-8328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCRIRIE",
        "first_name": "DALE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "DM010091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2893503",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsdale, MI

Sources for this page

Verify at the official NPI Registry.