Individual provider Active NPI

Jager Haan, MD

  • Vascular & Interventional Radiology Physician
  • Grand Rapids, MI
National Provider Identifier
1083467401
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
4351052982 Issued in MI
Practice address
3246 North Evergreen Dr. NE
Grand Rapids, MI 49525
Phone
(616) 459-7225
Fax
(616) 459-7271
NPI assigned
Apr 8, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 4351052982 MI
Vascular & Interventional Radiology Physician 2085R0204X 4351052982 MI Primary

Addresses

Primary practice location

3246 North Evergreen Dr. NE
Grand Rapids, MI 49525

Mailing address

100 Michigan St NE Ste A601
Grand Rapids, MI 49503-2560
Phone (616) 391-6243

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
I20240524001888 MI Order and Referring Only - Interventional RadiologyPractitioner - Interventional Radiology 2961844782

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4351052982MIMDVascular & Interventional Radiology Physician

Interoperability endpoints

  • Direct secure messaging: jhaan2469737@direct.trinity-health.org

NPI Registry JSON

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

{
    "created_epoch": "1712534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1083467401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE STE A601",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-391-6243",
            "fax_number": "616-391-8611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3246 NORTH EVERGREEN DR. NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49525",
            "telephone_number": "616-459-7225",
            "fax_number": "616-459-7271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAN",
        "first_name": "JAGER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-08",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4351052982",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MI",
            "license": "4351052982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.