Individual provider Active NPI

Dylan Joseph Carmichael, DO

  • Colon & Rectal Surgery Physician
  • Port Saint Lucie, FL
National Provider Identifier
1679102941
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
OS23592 Issued in FL
Practice address
900 SE Becker Rd
Port Saint Lucie, FL 34984-6641
Phone
(772) 800-5110
Fax
(772) 621-2935
NPI assigned
Apr 7, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X PA
Colon & Rectal Surgery Physician 208C00000X OS23592 FL Primary

Addresses

Primary practice location

900 SE Becker Rd
Port Saint Lucie, FL 34984-6641

Mailing address

PO Box 20800
Belfast, ME 04915-4105
Phone (888) 402-7256

Other practice location 1

Geisinger Medical Center 100 North Academy Avenue
Danville, PA 17822-0001
Phone (570) 271-6211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20260528000901 FL Practitioner - Colorectal Surgery (Proctology) 6800219023 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
New York College of Osteo Medicine of New York Institute of Technology, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

14201 Dallas Pkwy
Dallas, TX 75254-2916

1554 2ND St
Danville, PA 17821-1256

960 E 3Rd St
Chattanooga, TN 37403-2104

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS23592FLMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tenet Florida Physician Services LLC PastSince Aug 23, 2020 Accepting new patients

Organizations & group practices 1

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": "1586217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1679102941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20800",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154105",
            "telephone_number": "888-402-7256",
            "fax_number": "888-402-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 SE BECKER RD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349846641",
            "telephone_number": "772-800-5110",
            "fax_number": "772-621-2935"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Geisinger Medical Center 100 North Academy Avenue",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "PA",
            "postal_code": "178220001",
            "country_code": "US",
            "telephone_number": "570-271-6211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARMICHAEL",
        "first_name": "DYLAN",
        "middle_name": "JOSEPH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-07",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "FL",
            "license": "OS23592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

Verify at the official NPI Registry.