John Cavacece, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101013293 Issued in MI

Practice address

300 Lafayette Ave SE
Suite 4200
Grand Rapids, MI 49503-4650

Phone

(616) 685-6922

Fax

(616) 685-5105

NPI assigned

May 18, 2006

Last updated

Jun 26, 2009By the provider in NPPES

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jcavacece26082@direct.trinity-health.org

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.

• Advantage Health/Saint Mary's Medical Group

  dba Trinity Health Medical Group

  • Multi-Specialty Clinic/Center
  • Grand Rapids, MI
  • NPI 1376862151
  Medicare reassignment NPD
• Advantage Health Saint Mary's Medical Group

  dba Trinity Health Medical Group Orthopedics Grand Rapids

  • Orthopaedic Surgery Physician
  • Byron Center, MI
  • NPI 1003515008
  NPD
• Advantage Health Physicians PC

  • Family Medicine Physician
  • Grand Rapids, MI
  • NPI 1386695252
  NPD (past)
• Saint Mary's Health Services

  dba Mercy Health Saint Mary's

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1639111057
  NPD (past)
• Trinity Health - Michigan

  dba Heartside Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Grand Rapids, MI
  • NPI 1902002272
  NPD (past)

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245974400000",
    "number": "1093768244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 STATE ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034328",
            "telephone_number": "616-685-1808",
            "fax_number": "616-685-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LAFAYETTE AVE SE",
            "address_2": "SUITE 4200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034650",
            "telephone_number": "616-685-6922",
            "fax_number": "616-685-5105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVACECE",
        "first_name": "JOHN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2009-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101013293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4878391",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3290666",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3364634",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3415564",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3495251",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4597031",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ethan David Catron, LMSW CAADC
• Nichole Caudle, N.D., MT
• Nicole Caugherty Han
• Jamie L. Caughran, M.D.
• Esther Causene
• Kaitlyn Rose Cavanaugh, LMSW
• Lisa Jane Ealy Cavanaugh
• Claire Cavarretta
• Ally Cavataio, PA-C
• Michaela Maticevic Cavazos

• Family Medicine Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.