Individual provider Active NPI

Veronica Ichikawa Dillon

  • Clinical Neuropsychologist
  • Ann Arbor, MI
National Provider Identifier
1801164496
Registry record updated Aug 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
L2063630 Issued in MI
Practice address
5600 Meadow Dr
Ann Arbor, MI 48105-9368
Phone
(734) 484-6911
Fax
(734) 484-6913
NPI assigned
Dec 9, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X L2063630 MI Primary

Addresses

Primary practice location

5600 Meadow Dr
Ann Arbor, MI 48105-9368

Mailing address

5600 Meadow Dr
Ann Arbor, MI 48105-9368
Phone (734) 484-6911

Other practice location 1

2010 Hogback Rd Ste 6G
Ann Arbor, MI 48105-8800
Phone (734) 386-0041

Other practice location 2

1062 Orndorf Dr
Brighton, MI 48116-2308
Phone (734) 386-0041

Other names 1

  • Dr. Veronica Ichikawa Other name

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120423000572 MI Practitioner - Clinical Psychologist 8729249503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BCS of Michigan LLCGroup PAC ID 0840503652, 41 clinicians

Practice addresses (Care Compare)

3265 122ND Ave
R2
Allegan, MI 49010-9574
Phone (269) 673-2102

Merit-based Incentive Payment System (MIPS)

Final score
75.05 of 100Reported as group
Quality
0
Promoting interoperability
100
Improvement activities
40
Cost
83.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L2063630MIMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Geriatric Psychiatric Services PLLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1323388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1801164496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 MEADOW DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059368",
            "telephone_number": "734-484-6911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 MEADOW DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059368",
            "telephone_number": "734-484-6911",
            "fax_number": "734-484-6913"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2010 Hogback Rd Ste 6G",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481058800",
            "country_code": "US",
            "telephone_number": "734-386-0041",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1062 Orndorf Dr",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MI",
            "postal_code": "481162308",
            "country_code": "US",
            "telephone_number": "734-386-0041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DILLON",
        "first_name": "VERONICA",
        "middle_name": "ICHIKAWA",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-09",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MI",
            "license": "L2063630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VERONICA",
            "last_name": "ICHIKAWA",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.