Active NPI
Jason S. Dilly, M.D.
- Ophthalmology Physician
- Detroit, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 4301079310
- Practice address
- Henry Ford Health System
2799 West Grand Boulevard
Detroit, MI 48202 - Phone
- (313) 916-2436
- NPI assigned
- Dec 8, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 4301079310 | MI | Primary |
Addresses
Primary practice location
Henry Ford Health System
2799 West Grand Boulevard
Detroit, MI 48202
Mailing address
Henry Ford Health System
2799 West Grand Boulevard
Detroit, MI 48202
Phone (313) 916-2436
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| JD079310 | Other | CHAMPUS-CHAMPUS | |
| JD079310 | Other | COMMERCIAL-COMMERCIAL NUMBER |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Ophthalmology
- Education
- Columbia University College of Physicians and Surgeons, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600
6777 W Maple Rd
West Bloomfield, MI 48322-3013
Phone (248) 661-4100
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 174 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301079310 | MI | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Henry Ford Pathology | Current | Accepting new patients | |
| Henry Ford Health System | Ophthalmology | Current | Accepting new patients |
| Henry Ford Health System | Current | Accepting new patients |
Locations
1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953
2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062
6530 Farmington Rd
West Bloomfield, MI 48322
Phone (248) 451-6010
Interoperability endpoints
- jdilly16751@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.
-
- Ophthalmology Physician
- Detroit, MI
- NPI 1861576266
-
- Community/Retail Pharmacy
- Plymouth, MI
- NPI 1942931720
-
- Anatomic Pathology & Clinical Pathology Physician
- Detroit, MI
- NPI 1851410005
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Detroit, MI
- NPI 1134144801
-
dba Henry Ford West Bloomfield Hospital
- General Acute Care Hospital
- West Bloomfield, MI
- NPI 1407867559
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1740340140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "HENRY FORD HEALTH SYSTEM",
"address_2": "2799 WEST GRAND BOULEVARD",
"city": "DETROIT",
"state": "MI",
"postal_code": "48202",
"telephone_number": "313-916-2436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "HENRY FORD HEALTH SYSTEM",
"address_2": "2799 WEST GRAND BOULEVARD",
"city": "DETROIT",
"state": "MI",
"postal_code": "48202",
"telephone_number": "313-916-2436"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DILLY",
"first_name": "JASON",
"middle_name": "S.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "MI",
"license": "4301079310",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS-CHAMPUS",
"identifier": "JD079310",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMERCIAL-COMMERCIAL NUMBER",
"identifier": "JD079310",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.