NPIMap

Organization Active NPI

Hillsdale Pediatrics Clinic PC

  • Pediatric Adolescent Medicine Physician
  • Hillsdale, MI
National Provider Identifier
1992937148
Registry record updated Aug 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
MS086960 Issued in MI
Legal business name
HILLSDALE PEDIATRICS CLINIC PC
Practice address
451 Hidden Meadows Dr
Suite 200
Hillsdale, MI 49242-9812
Phone
(517) 437-8325
Fax
(517) 437-8327
NPI assigned
Aug 20, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2013

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

Authorized official

Name
Michael Sackman, M.D.NPI 1457387300
Title
Owner
Phone
(517) 437-8325

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080A0000X MS086960 MI Primary

Addresses

Primary practice location

451 Hidden Meadows Dr
Suite 200
Hillsdale, MI 49242-9812

Mailing address

1131 N Osseo Rd
P.O. Box 187
Hillsdale, MI 49242-9714
Phone (517) 523-3695

Other identifiers 2

IdentifierTypeStateIssuer
3503013872OtherBCBSM
105336218MedicaidMI

Other names 1

  • Hillsdale Pediatrics Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1250726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375747200000",
    "number": "1992937148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 N OSSEO RD",
            "address_2": "P.O. BOX 187",
            "city": "HILLSDALE",
            "state": "MI",
            "postal_code": "492429714",
            "telephone_number": "517-523-3695",
            "fax_number": "517-523-3311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 HIDDEN MEADOWS DR",
            "address_2": "SUITE 200",
            "city": "HILLSDALE",
            "state": "MI",
            "postal_code": "492429812",
            "telephone_number": "517-437-8325",
            "fax_number": "517-437-8327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILLSDALE PEDIATRICS CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-20",
        "last_updated": "2013-08-06",
        "status": "A",
        "authorized_official_last_name": "SACKMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-437-8325",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MI",
            "license": "MS086960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "3503013872",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105336218",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hillsdale Pediatrics",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Hillsdale, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.