NPIMap

Individual provider Active NPI

Michael B Dillon, MD

  • Gynecologic Oncology Physician
  • Macon, GA
National Provider Identifier
1346314069
Registry record updated Feb 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
73005 Issued in GA
Practice address
770 Pine St Ste 210
Macon, GA 31201-7512
Phone
(478) 845-7630
Fax
(478) 216-9178
NPI assigned
Nov 17, 2006
Last updated
Feb 20, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X 73005 GA Primary

Addresses

Primary practice location

770 Pine St Ste 210
Macon, GA 31201-7512

Mailing address

770 Pine St Ste 210
Macon, GA 31201-7512
Phone (478) 845-7630

Other identifiers 1

IdentifierTypeStateIssuer
581087004OtherFEI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150415000222 GA Practitioner - Gynecological Oncology 8123015641 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gynecological Oncology
Education
Georgetown University School of Medicine, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

770 Pine St
Suite 210
Macon, GA 31201-7512
Phone (478) 845-7630

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
73005GAMDGynecologic Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Macon Gynecologic Oncology LLC Gynecologic Oncology CurrentSince Jan 7, 2017 Accepting new patients
The Medical Center of Central Georgia Inc Past Accepting new patients
Central Georiga Fertility Institute Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

380 Hospital Dr
Bldg A
Macon, GA 31217
Phone (478) 751-0367

770 Pine St
Ste 210
Macon, GA 31201
Phone (478) 633-8383

797 Poplar St
Macon, GA 31201
Phone (912) 477-4818

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BGADAD/Endpoint/BGADAD
  • Direct secure messaging: michael.dillon@mgo.eclinicaldirectplus.com

Organizations & group practices 4

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": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550620800000",
    "number": "1346314069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 PINE ST STE 210",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312017512",
            "telephone_number": "478-845-7630",
            "fax_number": "478-216-9178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 PINE ST STE 210",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312017512",
            "telephone_number": "478-845-7630",
            "fax_number": "478-216-9178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLON",
        "first_name": "MICHAEL",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2019-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "GA",
            "license": "73005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEI",
            "identifier": "581087004",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.