Individual provider Active NPI

Brian James Daly, MD

  • Surgery Physician
  • Jackson, MI
National Provider Identifier
1790824225
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
4301051661 Issued in MI
Practice address
300 W Washington Ave
Suite 300
Jackson, MI 49201-2180
Phone
(517) 788-9677
Fax
(517) 841-1306
NPI assigned
Feb 5, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 4301051661 MI Primary

Addresses

Primary practice location

300 W Washington Ave
Suite 300
Jackson, MI 49201-2180

Mailing address

PO Box 67000
Department 272801
Detroit, MI 48267-2728
Phone (517) 841-6913

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
I20050322000870 MI Practitioner - General Surgery 1850346016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Wayne State University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

300 W Washington
300 Henry Ford Allegiance Vascular Health
Jackson, MI 49201-2160
Phone (517) 205-1305

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
W.a. Foote Memorial Hospital CurrentSince May 15, 2007 Accepting new patients
W. a. Foote Memorial Hospital Current Accepting new patients
Henry Ford Pathology Current Accepting new patients
Wa Foote Memorial Hospital CurrentSince May 15, 2007 Accepting new patients
Wa Foote Memorial Hospital, Inc Past Accepting new patients
Brian J Daly MD PLC Surgery PastSince Sep 1, 1998 Accepting new patients

Locations

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

300 W Washington Ave
Ste 300
Jackson, MI 49201
Phone (517) 205-1305

813 W Michigan Ave
Jackson, MI 49202
Phone (517) 205-1000

900 E Michigan Ave
Ste 108
Jackson, MI 49201
Phone (517) 788-9677

Interoperability endpoints

  • Direct secure messaging: bdaly456456@direct.hfhs.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790824225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67000",
            "address_2": "DEPARTMENT 272801",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482672728",
            "telephone_number": "517-841-6913",
            "fax_number": "517-841-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W WASHINGTON AVE",
            "address_2": "SUITE 300",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012180",
            "telephone_number": "517-788-9677",
            "fax_number": "517-841-1306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALY",
        "first_name": "BRIAN",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301051661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.