Individual provider Active NPI

Dana G Kissner, MD

  • Pulmonary Disease Physician
  • Detroit, MI
National Provider Identifier
1497793574
Registry record updated Sep 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
4301038391 Issued in MI
Practice address
3990 John R 6 Brush Ctr
Harper University Hospital
Detroit, MI 48201-2018
Phone
(313) 745-8516
Fax
(313) 745-7414
NPI assigned
Jun 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301038391 MI
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 4301038391 MI
Pulmonary Disease Physician 207RP1001X 4301038391 MI Primary

Addresses

Primary practice location

3990 John R 6 Brush Ctr
Harper University Hospital
Detroit, MI 48201-2018

Mailing address

1560 E Maple Rd
Suite 400-Credentialing
Troy, MI 48083-1138
Phone (313) 745-8516

Other names 1

  • Dana Gleicher Former name

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
I20060711000322 MI Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 1951314111 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Group Internal Medicine CurrentSince Oct 1, 2006 Accepting new patients
University Physician Group Past Accepting new patients
City of Detroit Past Accepting new patients

Locations

3990 John R St
#8
Detroit, MI 48201

4100 John R St
Detroit, MI 48201
Phone (313) 576-8530

3990 John R St
#6
Detroit, MI 48201
Phone (313) 745-8516

16001 W 9 Mile Rd
Southfield, MI 48075
Phone (248) 424-3000

1560 E Maple Rd
Ste 200
Troy, MI 48083
Phone (248) 581-5200

1560 E Maple Rd
Ste 400
Troy, MI 48083

Interoperability endpoints

  • Direct secure messaging: dkissner@direct.dmc.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473379200000",
    "number": "1497793574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 E MAPLE RD",
            "address_2": "SUITE 400-CREDENTIALING",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831138",
            "telephone_number": "313-745-8516",
            "fax_number": "313-745-7414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 JOHN R 6 BRUSH CTR",
            "address_2": "HARPER UNIVERSITY HOSPITAL",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012018",
            "telephone_number": "313-745-8516",
            "fax_number": "313-745-7414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISSNER",
        "first_name": "DANA",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2016-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301038391",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MI",
            "license": "4301038391",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MI",
            "license": "4301038391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANA",
            "last_name": "GLEICHER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.