Thomas J Ditkoff, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

4301030676 Issued in MI

Practice address

26025 Lahser Rd
2ND Floor
Southfield, MI 48033-2601

Phone

(248) 663-1900

Fax

(248) 663-1902

NPI assigned

Nov 14, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263254400000",
    "number": "1497736771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26025 LAHSER RD",
            "address_2": "2ND FLOOR",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480332601",
            "telephone_number": "248-663-1900",
            "fax_number": "248-663-1902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26025 LAHSER RD",
            "address_2": "2ND FLOOR",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480332601",
            "telephone_number": "248-663-1900",
            "fax_number": "248-663-1902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITKOFF",
        "first_name": "THOMAS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2010-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "4301030676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2751179",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0F31114",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADMINISTAR FEDERAL",
            "identifier": "0767220001",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS DME",
            "identifier": "0F33583",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Orthopaedic Surgery Physician in Southfield, MI
• Providers in Southfield, MI by specialty
• Orthopaedic Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.