Daniel M Metzger, MD
Individual provider Active NPI Family Medicine Physician · Niles, MI
NPI 1265478192 · NPPES record last updated Mar 7, 2023
Key facts
- NPI
- 1265478192
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 4301044672 (MI)
- Practice address
- 2002 S 11TH St
Niles, MI 49120-4074 - Phone
- (269) 687-0200
- Fax
- (269) 684-0199
- NPI assigned
- Jun 20, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100205000471 | MI | Practitioner - Family Practice |
1052495785 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01029510A | IN | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeland Medical Practices | Current |
Accepting new patients | |
| Lakeland Community Hospital Watervliet | Current |
Accepting new patients | |
| Lakeland Community Hospital Watervliet | Family Medicine | Current |
Accepting new patients |
| Lakeland Medical Practices | Current |
Accepting new patients | |
| Lakeland Community Hospital Watervliet | Current |
Accepting new patients | |
| Lakeland Community Hospital Watervliet | Family Medicine | Current | Accepting new patients |
Locations
6416 Deans Hill Rd
Berrien Ctr, MI 49102
Phone (269) 471-7741
31 N Saint Joseph Ave
Niles, MI 49120
Phone (269) 428-2417
2002 S 11th St
Niles, MI 49120
Phone (269) 687-0200
3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990
400 Medical Park Dr
Watervliet, MI 49098
Phone (269) 463-3111
Interoperability endpoints
- https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/
- dmetzger1270863@epic00.corewelldirect.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 01029510A | IN | |
| Family Medicine Physician | 207Q00000X | 4301044672 | MI | Yes |
Addresses
Primary practice location
2002 S 11TH St
Niles, MI 49120-4074
Mailing address
2002 S 11TH St
Niles, MI 49120-4074
Phone (269) 687-0200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 80085309 | Other | MI | RAILROAD MEDICARE |
| 2894019 | Medicaid | MI | |
| 0111100142 | Other | MI | BLUE CROSS PIN |
Other providers in Niles, MI
- David Michael McIntosh
- Susanna C McKinley
- Medicaid Home Services LLC
- Janet Meredith
- Ogubay Tekie Mesmer
- Michiana Counseling Services Inc
- Michiana Guardianship Services, Inc.
- Michiana Hematology Oncology of Michigan, P.C.
- Michiana Hematology Oncology of Michigan, P.C.
- Michiana Home Care, LLC
All providers in Niles, MI · Family Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.