NPIMap

Individual provider Active NPI

Dylan Thomas Mooney

  • Family Medicine Physician
  • Grand Blanc, MI
National Provider Identifier
1710335641
Registry record updated Apr 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101022387 Issued in MI
Practice address
1 Genesys Pkwy
Medical Education
Grand Blanc, MI 48439-8065
Phone
(810) 606-5126
NPI assigned
Jun 1, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101022387 MI Primary

Addresses

Primary practice location

1 Genesys Pkwy
Medical Education
Grand Blanc, MI 48439-8065

Mailing address

1 Genesys Pkwy
Medical Education
Grand Blanc, MI 48439-8065

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dylanmooney@migra.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200211000837 MI Practitioner - Family Practice 5294023099 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health Genesys HospitalGroup PAC ID 2062323033, 85 clinicians

Practice addresses (Care Compare)

1460 N Ctr Rd
Burton, MI 48509-1429
Phone (810) 715-4300

Hospital & facility affiliations

  • Ascension Genesys Hospital Hospital, Grand Blanc, MI, CCN 230197

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health Genesys Hospital Family Medicine CurrentSince Jan 24, 2020 Accepting new patients
Ascension Genesys Hospital CurrentSince Jan 24, 2020 Accepting new patients
Recovery Physicians Network of Michigan CurrentSince Apr 5, 2023 Accepting new patients
Henry Ford Health Genesys Hospital Current Accepting new patients
Mooney Medical Group PLLC Family Medicine Current Accepting new patients
Silver Lake Family Practice PLLC Family Medicine CurrentSince Feb 19, 2020 Accepting new patients
Henry Ford Health Genesys Hospital Past Accepting new patients

Locations

1460 N Center Rd
Burton, MI 48509
Phone (810) 424-2011

1100 Torrey Rd
Ste 400
Fenton, MI 48430
Phone (810) 714-7369

420 S Saginaw St
Flint, MI 48502
Phone (810) 232-3522

1 Genesys Pkwy
Grand Blanc, MI 48439
Phone (810) 606-5733

101 W Townsend Rd
Saint Johns, MI 48879
Phone (989) 403-6022

Interoperability endpoints

  • Direct secure messaging: dmooney382612@direct.hfhs.org
  • FHIR API: https://api.platform.athenahealth.com/8209/brand/5/csg/21/fhir/r4

Organizations & group practices 10

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1464739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1710335641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GENESYS PKWY",
            "address_2": "MEDICAL EDUCATION",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GENESYS PKWY",
            "address_2": "MEDICAL EDUCATION",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398065",
            "telephone_number": "810-606-5126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOONEY",
        "first_name": "DYLAN",
        "middle_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-01",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101022387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dylanmooney@migra.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "1460 N Center Rd",
            "city": "Burton",
            "state": "MI",
            "country_code": "US",
            "postal_code": "485091429",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

Verify at the official NPI Registry.