NPIMap

Individual provider Active NPI

Daniel K Wilcox, M.D.

  • Orthopaedic Surgery Physician
  • Petoskey, MI
National Provider Identifier
1386653103
Registry record updated Sep 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
4301065867 Issued in MI
Practice address
4048 Cedar Bluff Dr
Suite 1
Petoskey, MI 49770-8895
Phone
(231) 347-5155
Fax
(231) 347-6128
NPI assigned
Aug 8, 2006
Last updated
Sep 26, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 4301065867 MI Primary

Addresses

Primary practice location

4048 Cedar Bluff Dr
Suite 1
Petoskey, MI 49770-8895

Mailing address

1140 N State St
Saint Ignace, MI 49781-1048
Phone (906) 328-2148

Other identifiers 1

IdentifierTypeStateIssuer
4326997MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20110802000162 MI Practitioner - Orthopedic Surgery 9032309133 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Michigan Medical School, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mackinac Straits Health System IncGroup PAC ID 1456420876, shared by 7 NPIs, 19 clinicians

Practice addresses (Care Compare)

1140 N State St
Saint Ignace, MI 49781-1048
Phone (906) 643-8585

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301065867MIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mackinac Straits Health System Inc Current Accepting new patients
Mackinac Straits Health System Inc CurrentSince Oct 1, 2019 Accepting new patients
Mackinac Straits Health System Inc CurrentSince Oct 1, 2019 Accepting new patients
Mackinac Straits Health System Inc Past Accepting new patients
Daniel K Wilcox MD PC Orthopaedic Surgery PastSince Jul 26, 2001 Accepting new patients

Locations

14540 N Mackinaw Hwy
Mackinaw City, MI 49701
Phone (231) 436-9900

1140 N State St
Saint Ignace, MI 49781
Phone (906) 643-0466

Interoperability endpoints

  • Direct secure messaging: danielwilcox@mshs.allscriptsdirect.net
  • Direct secure messaging: dwilcox128157@mymichiganhealth.midirect.net

Organizations & group practices 8

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 5

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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1386653103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 N STATE ST",
            "city": "SAINT IGNACE",
            "state": "MI",
            "postal_code": "497811048",
            "telephone_number": "906-328-2148",
            "fax_number": "906-643-6509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4048 CEDAR BLUFF DR",
            "address_2": "SUITE 1",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497708895",
            "telephone_number": "231-347-5155",
            "fax_number": "231-347-6128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCOX",
        "first_name": "DANIEL",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "4301065867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4326997",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Petoskey, MI

Sources for this page

Verify at the official NPI Registry.