Individual provider Active NPI

Emmanuel Plenos Dizon, M.D.

  • Internal Medicine Physician
  • Detroit, MI
National Provider Identifier
1447328984
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301073823 Issued in MI
Practice address
Henry Ford Medical Group - Detroit Northwest
7800 W Outer Drive
Detroit, MI 48235
Phone
(313) 653-2300
Fax
(313) 653-2660
NPI assigned
Dec 1, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

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
Internal Medicine Physician 207R00000X 4301073823 MI Primary

Addresses

Primary practice location

Henry Ford Medical Group - Detroit Northwest
7800 W Outer Drive
Detroit, MI 48235

Mailing address

Henry Ford Medical Group - Detroit Northwest
7800 W Outer Drive
Detroit, MI 48235
Phone (313) 653-2300

Other identifiers 2

IdentifierTypeStateIssuer
ED073823OtherCHAMPUS-CHAMPUS
ED073823OtherCOMMERCIAL-COMMERCIAL NUMBER

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
I20100604000974 MI Practitioner - Internal Medicine 2860522604 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Michigan Medical School, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

1 Ford PL
Detroit, MI 48202-3450
Phone (313) 874-6677

2799 W Grand Blvd
Detroit, MI 48202-2608

5500 Auto Club Dr
Dearborn, MI 48126-2779
Phone (313) 425-4500

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Current Accepting new patients
Henry Ford Health System Internal Medicine CurrentSince Jul 8, 2002 Accepting new patients
Henry Ford Health System CurrentSince Jul 8, 2002 Accepting new patients

Locations

1 Ford Pl
#2E
Detroit, MI 48202
Phone (313) 874-4688

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

7800 W Outer Dr
Detroit, MI 48235
Phone (313) 387-8800

159 Kercheval Ave
Grosse Pointe Farms, MI 48236
Phone (313) 640-1000

3500 15 Mile Rd
Sterling Hts, MI 48310
Phone (586) 977-9300

Interoperability endpoints

  • Direct secure messaging: edizon13315@direct.hfhs.org

Organizations & group practices 3

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": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447328984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HENRY FORD MEDICAL GROUP - DETROIT NORTHWEST",
            "address_2": "7800 W OUTER DRIVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48235",
            "telephone_number": "313-653-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HENRY FORD MEDICAL GROUP - DETROIT NORTHWEST",
            "address_2": "7800 W OUTER DRIVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48235",
            "telephone_number": "313-653-2300",
            "fax_number": "313-653-2660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIZON",
        "first_name": "EMMANUEL",
        "middle_name": "PLENOS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301073823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS-CHAMPUS",
            "identifier": "ED073823",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL-COMMERCIAL NUMBER",
            "identifier": "ED073823",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.