Individual provider Active NPI

Danielle Ann Bly Brack, M.D.

  • Diagnostic Radiology Physician
  • Toledo, OH
National Provider Identifier
1730642802
Registry record updated Sep 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
35.154043 Issued in OH
Practice address
5757 Park Center CT.
Toledo, OH 43615
Phone
(419) 474-4064
Fax
(419) 472-2772
NPI assigned
Apr 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 4301511363 MI
Diagnostic Radiology Physician 2085R0202X 35.154043 OH Primary

Addresses

Primary practice location

5757 Park Center CT.
Toledo, OH 43615

Mailing address

5757 Park Center CT.
Toledo, OH 43615
Phone (419) 474-4064

Other practice location 1

1500 E Medical Center Dr # B1D502
Ann Arbor, MI 48109-5000
Phone (734) 647-4144

Other names 1

  • Danielle Ann Bly Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240729004077 MI Practitioner - Diagnostic Radiology 9931646726 Reassigns benefits to 3 organizations
I20250828000275 OH Practitioner - Diagnostic Radiology 9931646726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Indiana University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Toledo Radiological Associates IncGroup PAC ID 2567367519, 51 clinicians

Practice addresses (Care Compare)

2142 N Cove Blvd
Toledo, OH 43606-3895
Phone (317) 614-9881

718 N Macomb St
Monroe, MI 48162-7815
Phone (419) 474-4064

Hospital & facility affiliations

  • Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068
  • Promedica Monroe Regional Hospital Hospital, Monroe, MI, CCN 230099
  • Promedica Charles and Virginia Hickman Hospital Hospital, Adrian, MI, CCN 230005
  • Bay Park Community Hospital Hospital, Oregon, OH, CCN 360259
  • Memorial Hospital Hospital, Fremont, OH, CCN 360156

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.154043OHMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan Diagnostic Radiology CurrentSince Jul 1, 2024 Accepting new patients
Regents of the University of Michigan Current Accepting new patients
Toledo Radiological Associates, Inc. Diagnostic Radiology CurrentSince Aug 1, 2025 Accepting new patients
Regents of the University of Michigan CurrentSince Jul 1, 2024 Accepting new patients
Metropolitan Hospital CurrentSince Jul 1, 2024 Accepting new patients
University of Toledo Physicians LLC Diagnostic Radiology PastSince Aug 17, 2025 Accepting new patients

Locations

5640 N Adrian Hwy
Adrian, MI 49221
Phone (419) 291-3000

1500 E Medical Center Dr
#D
Ann Arbor, MI 48109
Phone (734) 936-5823

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

1500 E Medical Center Dr
#B1D502
Ann Arbor, MI 48109
Phone (734) 615-4924

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

274 E Chicago St
Coldwater, MI 49036
Phone (517) 279-5400

718 N Macomb St
Monroe, MI 48162
Phone (734) 212-3097

5900 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 252-3243

5301 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-7246

2801 Bay Park Dr
Oregon, OH 43616
Phone (419) 690-7652

5757 Park Center Ct
Toledo, OH 43615

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

Organizations & group practices 6

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 7

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": "1554595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758844800000",
    "number": "1730642802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5757 PARK CENTER CT.",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "43615",
            "telephone_number": "419-474-4064",
            "fax_number": "419-472-2772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5757 PARK CENTER CT.",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "43615",
            "telephone_number": "419-474-4064",
            "fax_number": "419-472-2772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 E Medical Center Dr # B1D502",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481095000",
            "country_code": "US",
            "telephone_number": "734-647-4144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLY BRACK",
        "first_name": "DANIELLE",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-07",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301511363",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35.154043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "BLY",
            "middle_name": "ANN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.