Individual provider Active NPI

Bridget Catherine Dillon, DO

  • Pediatrics Physician
  • Detroit, MI
National Provider Identifier
1639639115
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
5101026832 Issued in MI
Practice address
3901 Beaubien St
Detroit, MI 48201-2119
Phone
(313) 745-5870
NPI assigned
Mar 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 5101026832 MI Primary

Addresses

Primary practice location

3901 Beaubien St
Detroit, MI 48201-2119

Mailing address

4201 Saint Antoine St
9C-Uhc
Detroit, MI 48201-2153
Phone (313) 745-5146

Other practice location 1

500 University Dr
Hershey, PA 17033-2360
Phone (717) 531-1368

Other identifiers 1

IdentifierTypeStateIssuer
5101026832OtherMIMICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS

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
I20230801004282 MI Practitioner - Pediatric Medicine 5698001352 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Pediatricians Pediatrics CurrentSince Jul 26, 2023 Accepting new patients
University Pediatricians Pediatrics CurrentSince Jul 26, 2023 Accepting new patients
VHS Childrens Hospital of Michigan Inc Past Accepting new patients
VHS Harper-Hutzel Hospital Inc Past Accepting new patients

Locations

4201 Saint Antoine St
#9
Detroit, MI 48201
Phone 3137455146 ext. 5147

3901 Beaubien St
Ste H
Detroit, MI 48201
Phone (313) 745-5437

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

Organizations & group practices 4

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": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1639639115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST",
            "address_2": "9C-UHC",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-745-5146",
            "fax_number": "313-966-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 BEAUBIEN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012119",
            "telephone_number": "313-745-5870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 University Dr",
            "address_purpose": "LOCATION",
            "city": "Hershey",
            "state": "PA",
            "postal_code": "170332360",
            "country_code": "US",
            "telephone_number": "717-531-1368",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DILLON",
        "first_name": "BRIDGET",
        "middle_name": "CATHERINE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-21",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "5101026832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS",
            "identifier": "5101026832",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.