Active NPI
Johnathan Daniel Dallas, MD
- Pediatrics Physician
- Madison, WI
National Provider Identifier
1386586261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 102237-851
- Practice address
- 600 Highland Ave
Madison, WI 53792-0001 - Phone
- (608) 263-6400
- NPI assigned
- Apr 8, 2026
- Sex
- Male
- Sole proprietor
- No
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260601003359 | WI | Order and Referring Only - Pediatric Medicine | 5597235473 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 102237-851 | WI | MD | Pediatrics Physician |
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 102237-851 | WI | Primary |
Addresses
Primary practice location
600 Highland Ave
Madison, WI 53792-0001
Mailing address
600 Highland Ave
Madison, WI 53792-0001
Phone (608) 263-6400
NPI Registry JSON
{
"created_epoch": "1775606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780531200000",
"number": "1386586261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 HIGHLAND AVE",
"city": "MADISON",
"state": "WI",
"postal_code": "537920001",
"telephone_number": "608-263-6400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 HIGHLAND AVE",
"city": "MADISON",
"state": "WI",
"postal_code": "537920001",
"telephone_number": "608-263-6400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DALLAS",
"first_name": "JOHNATHAN",
"middle_name": "DANIEL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-04-08",
"last_updated": "2026-06-04",
"certification_date": "2026-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WI",
"license": "102237-851",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.