CHRIS J DICKINSON (MD) – Pediatrics Physician, NPI 1366456543

CHRIS J DICKINSON (MD) is a healthcare provider. based in Ann arbor, Michigan. specializing in PEDIATRIC MEDICINE, GASTROENTEROLOGY. They hold the professional credentials MD. They hold a License No. 4301048129 (MI). The NPI Number for CHRIS J DICKINSON (MD) is 1366456543

Main info

Male
45 Years Of Experience
Accepts Medicare Assignment
Name
CHRIS J DICKINSON (MD)
NPI
1366456543
Phone
(734) 936-2047
Address
3621 S STATE ST
Enumeration Date
27 July 2006
Last Update Date
14 October 2013

Doctor Profile

Medical School Name
WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
7346478901
Graduation Year
1981 (45 years ago)
PAC ID
8820151194
Group Practice PAC ID
3779496856
Professional Enrollment ID
I20090113000287
Address ID
MI481090999AN1500XLEVE601
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,204 PEDIATRIC MEDICINE in MI

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Provider Addresses for CHRIS J DICKINSON (MD)

  • South State Street, Ann Arbor, Washtenaw County, Michigan, 48108-1774, United States

    700 KMS PLACE ATTN ELLEN KAYFES

    ANN ARBOR, MI 48108

    Phone: (734) 936-2047

    Type: Mailing

  • Mott Children's Hospital and Von Voigtlander Women's Hospital, 1500, East Medical Center Drive, Ann Arbor, Washtenaw County, Michigan, 48109, United States

    8TH FLOOR CS MOTT CHILDRENS HOSPITAL

    ANN ARBOR, MI 481094259

    Phone: (734) 936-4185

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2009-01-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20090113000287IPediatric MedicineMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48108)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3779496856View full group profile
NameSpecialtyState
G A S T R O E N T E R O L O G YFL
Physical Medicine And RehabilitationMI
A N E S T H E S I O L O G YMI
Internal Medicine, Pediatric MedicineIL
-MI
Physician AssistantMI

Reviews

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Frequently asked questions

Is CHRIS J DICKINSON (MD) listed with a National Provider Identifier?
Yes — CHRIS J DICKINSON (MD) has NPI 1366456543 on file in the registry.
Is CHRIS J DICKINSON (MD) still an active registrant?
CHRIS J DICKINSON (MD) carries an active NPI according to the public dataset.
What clinical focus is listed for CHRIS J DICKINSON (MD)?
At a glance, CHRIS J DICKINSON (MD) is tied to Pediatrics Physician. Clinical services aligned with this taxonomy classification.
Is CHRIS J DICKINSON (MD) located near Ann Arbor?
CHRIS J DICKINSON (MD) currently maps to Ann Arbor, Michigan in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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