Individual provider Active NPI

Migel Brandon Enriquez Dalusung

  • Physician Assistant
  • Pontiac, MI
National Provider Identifier
1699540153
Registry record updated Jan 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
461 W Huron St Ste 107
Pontiac, MI 48341-1601
Phone
(248) 724-7600
Fax
(248) 724-6800
NPI assigned
Nov 15, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

461 W Huron St Ste 107
Pontiac, MI 48341-1601

Mailing address

461 W Huron St
Pontiac, MI 48341-1601
Phone (248) 724-7600

Other practice location 1

11800 E 12 Mile Rd
Warren, MI 48093-3472
Phone (248) 724-7600

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address migel.dalusung.p1@direct.oihn.nextgenshare.com

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240926001834 MI Practitioner - Physician Assistant 9234670506 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Oakland Integrated Healthcare Network CurrentSince Aug 12, 2024 Accepting new patients
Oakland Integrated Healthcare Network CurrentSince Aug 12, 2024 Accepting new patients
Oakland Integrated Healthcare Network Past Accepting new patients

Locations

461 W Huron St
Ste 107
Pontiac, MI 48341
Phone (248) 857-7432

48980 Woodward Ave
Pontiac, MI 48342
Phone (248) 724-7400

Interoperability endpoints

  • Direct secure messaging: mdalusung1124394@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.

NPI Registry JSON

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

{
    "created_epoch": "1700006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769472000000",
    "number": "1699540153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 W HURON ST",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483411601",
            "telephone_number": "248-724-7600",
            "fax_number": "248-724-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 W HURON ST STE 107",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483411601",
            "telephone_number": "248-724-7600",
            "fax_number": "248-724-6800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11800 E 12 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "MI",
            "postal_code": "480933472",
            "country_code": "US",
            "telephone_number": "248-724-7600",
            "fax_number": "248-724-6800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DALUSUNG",
        "first_name": "MIGEL BRANDON",
        "middle_name": "ENRIQUEZ",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-15",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "migel.dalusung.p1@direct.oihn.nextgenshare.com",
            "affiliation": "N",
            "address_1": "461 W Huron St Ste 107",
            "city": "Pontiac",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483411601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.