Ryan E Dodde II, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

4301063317 Issued in MI

Practice address

3124 N Wellness Dr
Suite 10
Holland, MI 49424-8121

Phone

(616) 738-5870

Fax

(616) 738-5872

NPI assigned

Feb 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

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

Specialty

Plastic and Reconstructive Surgery

Education

Wayne State University School of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holland Hospital Hospital, Holland, MI, CCN 230072
• University of Michigan Health System Hospital, Ann Arbor, MI, CCN 230046
• Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Lakeshore Plastic and Reconstructive Surgery Associates, P.C.

  • Plastic Surgery Physician
  • Holland, MI
  • NPI 1467641373
  Medicare reassignment NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Holland Community Hospital

  • General Acute Care Hospital
  • Holland, MI
  • NPI 1871672618
  Care Compare affiliation
• Pennock Hospital

  • Critical Access Hospital
  • Hastings, MI
  • NPI 1932695525
  Care Compare affiliation
• Regents of the University of Michigan

  • General Acute Care Hospital
  • Ann Arbor, MI
  • NPI 1003878539
  Care Compare affiliation
• Spectrum Health Hospitals

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1922090554
  Care Compare affiliation

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

{
    "created_epoch": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192579200000",
    "number": "1881669299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3124 N WELLNESS DR",
            "address_2": "SUITE 10",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248121",
            "telephone_number": "616-738-5870",
            "fax_number": "616-738-5872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3124 N WELLNESS DR",
            "address_2": "SUITE 10",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248121",
            "telephone_number": "616-738-5870",
            "fax_number": "616-738-5872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODDE",
        "first_name": "RYAN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-20",
        "last_updated": "2007-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MI",
            "license": "4301063317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PIN NUMBER",
            "identifier": "07010911",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBA INSURANCE ID NUMBER",
            "identifier": "13-30028",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CHOICES ID NO.",
            "identifier": "128516",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PPO ID NUMBER",
            "identifier": "2221956",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA ID NUMBER",
            "identifier": "7254148",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID NUMBER",
            "identifier": "24-07010911",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roberta Jean Dischinger-Smedes, MSN, APRN, BC, FNP
• Brian Norbert Dishinger, MD
• Diverse Home Health Care
• Krzysztof Dlugosz, P.T.
• Monika Dlugosz
• William D Doebler, MD
• James Patrick Doherty, PSYD
• Stylianos G Dokianakis, AU.D.
• Lydia Dominguez
• Charles D Donaldson, LLP, LPC

• Plastic Surgery Physician in Holland, MI
• Providers in Holland, MI by specialty
• Plastic Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.

Verify at the official NPI Registry.