Individual provider Active NPI

Diana Marie Flis, M.D.

  • Plastic Surgery Physician
  • Jackson, MI
National Provider Identifier
1972890085
Registry record updated Feb 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
4301098769 Issued in MI
Practice address
3305 Spring Arbor Rd Ste 200
Jackson, MI 49203-3995
Phone
(517) 205-2107
NPI assigned
Jul 9, 2011
Last updated
Feb 28, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 4301098769 MI Primary

Addresses

Primary practice location

3305 Spring Arbor Rd Ste 200
Jackson, MI 49203-3995

Mailing address

6830 Price Lake Rd N
Jackson, MI 49201-8013
Phone (313) 300-9630

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
I20190221001708 MI Practitioner - Plastic and Reconstructive Surgery 5597067884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3305 Spring Arbor Rd
Suite 200
Jackson, MI 49203-3995
Phone (517) 205-2107

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301098769MIMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
W.a. Foote Memorial Hospital, Inc CurrentSince Jan 1, 2019 Accepting new patients
W. a. Foote Memorial Hospital, Inc Current Accepting new patients
W.a. Foote Memorial Hospital, Inc Plastic and Reconstructive Surgery CurrentSince Jan 1, 2019 Accepting new patients
Wa Foote Memorial Hospital, Inc Past Accepting new patients

Locations

3305 Spring Arbor Rd
Ste 200
Jackson, MI 49203
Phone (517) 205-1285

3333 Spring Arbor Rd
Ste 500
Jackson, MI 49203
Phone (517) 205-2106

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

Interoperability endpoints

  • Direct secure messaging: dflis555890@direct.hfhs.org

Organizations & group practices 4

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": "1310169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551312000000",
    "number": "1972890085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6830 PRICE LAKE RD N",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492018013",
            "telephone_number": "313-300-9630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3305 SPRING ARBOR RD STE 200",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492033995",
            "telephone_number": "517-205-2107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLIS",
        "first_name": "DIANA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-09",
        "last_updated": "2019-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MI",
            "license": "4301098769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.