Individual provider Active NPI

James Dragonette, MD

  • Neurological Surgery Physician
  • Southfield, MI
National Provider Identifier
1740806520
Registry record updated Jun 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
4351046855 Issued in MI
Practice address
22250 Providence Dr Ste 601
Southfield, MI 48075-6214
Phone
(248) 569-7745
Fax
(248) 569-4539
NPI assigned
Jun 17, 2020
Last updated
Jun 17, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 4351046855 MI Primary

Addresses

Primary practice location

22250 Providence Dr Ste 601
Southfield, MI 48075-6214

Mailing address

22250 Providence Dr Ste 601
Southfield, MI 48075-6214
Phone (248) 569-7745

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
I20200619001101 MI Order and Referring Only - NeurosurgeryPractitioner - Neurosurgery 5496177453

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1592352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1740806520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR STE 601",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480756214",
            "telephone_number": "248-569-7745",
            "fax_number": "248-569-4539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR STE 601",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480756214",
            "telephone_number": "248-569-7745",
            "fax_number": "248-569-4539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAGONETTE",
        "first_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-17",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MI",
            "license": "4351046855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.