Individual provider Active NPI

Robert H Dickason, DO

  • Colon & Rectal Surgery Physician
  • Trenton, MI
National Provider Identifier
1710979869
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
RD006962 Issued in MI
Practice address
2674 W Jefferson Ave Ste 201
Trenton, MI 48183-2800
Phone
(734) 676-5353
Fax
(734) 676-5524
NPI assigned
Aug 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X RD006962 MI
Colon & Rectal Surgery Physician 208C00000X RD006962 MI Primary

Addresses

Primary practice location

2674 W Jefferson Ave Ste 201
Trenton, MI 48183-2800

Mailing address

6707 38TH Ave N
St Petersburg, FL 33710-1536
Phone (734) 676-5353

Other practice location 1

5400 Fort St Ste 210
Trenton, MI 48183-4630
Phone (734) 676-5353

Other identifiers 2

IdentifierTypeStateIssuer
2114889MedicaidMI
05820096OtherMIBCBS

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
I20051103000384 MI Practitioner - General SurgeryPractitioner - Colorectal Surgery (Proctology) 7012935539 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Colorectal Surgery (Proctology)
Education
Midwestern University, Chicago College of Osteopathic Med, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2674 W Jefferson Ave
Suite 201
Trenton, MI 48183-2800
Phone (734) 676-5353

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RD006962MIMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
My Kit Free LLC CurrentSince Feb 1, 2023 Accepting new patients
Oakwood Group IX, LLC Surgery Past Accepting new patients

Locations

6707 38th Ave N
St Petersburg, FL 33710
Phone (727) 800-9958

5400 Fort St
Ste 210
Trenton, MI 48183
Phone (734) 676-5353

Interoperability endpoints

  • Direct secure messaging: rhdickason@rhddopc-mi.direct.office.nextgen.com

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 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": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1710979869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6707 38TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337101536",
            "telephone_number": "734-676-5353",
            "fax_number": "734-676-5524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2674 W JEFFERSON AVE STE 201",
            "city": "TRENTON",
            "state": "MI",
            "postal_code": "481832800",
            "telephone_number": "734-676-5353",
            "fax_number": "734-676-5524"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5400 Fort St Ste 210",
            "address_purpose": "LOCATION",
            "city": "Trenton",
            "state": "MI",
            "postal_code": "481834630",
            "country_code": "US",
            "telephone_number": "734-676-5353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKASON",
        "first_name": "ROBERT",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "RD006962",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "MI",
            "license": "RD006962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2114889",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "05820096",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, MI

Sources for this page

Verify at the official NPI Registry.