Individual provider Active NPI

Colleen Bryzik Dodich, MD

  • Pediatrics Physician
  • Kalamazoo, MI
National Provider Identifier
1699989384
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301087834 Issued in MI
Practice address
5629 Stadium Dr
Kalamazoo, MI 49009-1952
Phone
(269) 372-1000
Fax
(269) 372-0474
NPI assigned
May 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 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 4301087834 MI Primary

Addresses

Primary practice location

5629 Stadium Dr
Kalamazoo, MI 49009-1952

Mailing address

5629 Stadium Dr
Kalamazoo, MI 49009-1952
Phone (269) 372-1000

Other names 1

  • Colleen Marie Bryzik Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.bronsonhg.org Direct

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
I20100319000036 MI Practitioner - Pediatric Medicine 1850426594 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301087834MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bronson Methodist Hospital CurrentSince Feb 1, 2016 Accepting new patients
Michigan State University Kalamazoo Center for Medical Studies Past Accepting new patients

Locations

300 North Ave
Fl 2
Battle Creek, MI 49017
Phone (269) 245-5862

5629 Stadium Dr
Kalamazoo, MI 49009
Phone (269) 372-1000

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

1000 Oakland Dr
Kalamazoo, MI 49008
Phone (269) 337-4347

601 John St
#2
Kalamazoo, MI 49007

5629 Stadium Dr
Ste A
Kalamazoo, MI 49009
Phone (269) 372-1000

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

Interoperability endpoints

  • Direct secure messaging: direct@direct.bronsonhg.org
  • Direct secure messaging: cdodich10877@direct.bronsonhg.org

Organizations & group practices 2

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": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1699989384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5629 STADIUM DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490091952",
            "telephone_number": "269-372-1000",
            "fax_number": "269-372-0698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5629 STADIUM DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490091952",
            "telephone_number": "269-372-1000",
            "fax_number": "269-372-0474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODICH",
        "first_name": "COLLEEN",
        "middle_name": "BRYZIK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-10",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301087834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "COLLEEN",
            "last_name": "BRYZIK",
            "middle_name": "MARIE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.