Individual provider Active NPI

Daniel Merck

  • Family Medicine Physician
  • Grand Rapids, MI
National Provider Identifier
1164080669
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5151013944 Issued in MI
Practice address
1000 E Paris Ave SE Ste 100
Grand Rapids, MI 49546-3680
Phone
(616) 459-3158
NPI assigned
May 31, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5151013944 MI Primary

Addresses

Primary practice location

1000 E Paris Ave SE Ste 100
Grand Rapids, MI 49546-3680

Mailing address

1000 E Paris Ave SE Ste 100
Grand Rapids, MI 49546-3680
Phone (616) 459-3158

Other practice location 1

2093 Health Dr SW Ste 200
Wyoming, MI 49519-9691
Phone (616) 459-3158

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
I20210914000799 MI Practitioner - Family Practice 6800292061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakewood Family Medicine PLCGroup PAC ID 0749290740, 16 clinicians

Practice addresses (Care Compare)

382 N 120TH Ave
Holland, MI 49424-2169
Phone (616) 396-6516

Hospital & facility affiliations

  • Holland Hospital Hospital, Holland, MI, CCN 230072

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5151013944MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakewood Family Medicine PLC Family Medicine CurrentSince Jul 1, 2024 Accepting new patients
Mercy Health Partners PastSince Sep 13, 2021 Accepting new patients

Locations

382 N 120th Ave
Holland, MI 49424
Phone (616) 396-6516

Interoperability endpoints

  • Direct secure messaging: dmerck42794@direct.trinity-health.org
  • Direct secure messaging: danielmerck@lwfm.allscriptsdirect.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1559260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1164080669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E PARIS AVE SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463680",
            "telephone_number": "616-459-3158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E PARIS AVE SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463680",
            "telephone_number": "616-459-3158"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2093 Health Dr SW Ste 200",
            "address_purpose": "LOCATION",
            "city": "Wyoming",
            "state": "MI",
            "postal_code": "495199691",
            "country_code": "US",
            "telephone_number": "616-459-3158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MERCK",
        "first_name": "DANIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-31",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5151013944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.