NPIMap

Individual provider Active NPI

Douglas R. Dehaan, MD

  • Family Medicine Physician
  • Farmington Hills, MI
National Provider Identifier
1376548107
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301511075 Issued in MI
Practice address
27810 Grand River Ave
Farmington Hills, MI 48336-5916
Phone
(248) 516-1978
NPI assigned
Jun 17, 2005
Last updated
Apr 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1919 SD
Family Medicine Physician 207Q00000X 4301511075 MI Primary

Addresses

Primary practice location

27810 Grand River Ave
Farmington Hills, MI 48336-5916

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-9600

Other practice location 1

7220 W 41st St
Sioux Falls, SD 57106-6028
Phone (605) 328-9600

Other identifiers 1

IdentifierTypeStateIssuer
5607207MedicaidSD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ddehaan3585@direct.sanfordhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240418003638 MI Practitioner - Family Practice 7416978705 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstreet Urgent Care of MichiganGroup PAC ID 6305188491, 129 clinicians

Practice addresses (Care Compare)

27810 Grand River Ave
Farmington Hills, MI 48336-5916
Phone (248) 957-1989

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
76.04 of 100Reported as group
Quality
67.93
Promoting interoperability
100
Improvement activities
40
Cost
52.21

Merit-based Incentive Payment System (MIPS)

Final score
84.78 of 100Reported as group
Quality
78.77
Promoting interoperability
100
Improvement activities
40
Cost
70.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301511075MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstreet Urgent Care of Michigan CurrentSince Apr 15, 2024 Accepting new patients
Wellstreet Urgent Care of Michigan CurrentSince Apr 15, 2024 Accepting new patients
Wellstreet Urgent Care of Michigan PastSince Aug 6, 2023 Accepting new patients

Locations

1825 Highway 34 E
Ste 1200
Newnan, GA 30265
Phone (770) 502-2112

27810 Grand River Ave
Farmington Hills, MI 48336
Phone (248) 516-1978

2078 E Big Beaver Rd
Troy, MI 48083
Phone (248) 855-4134

Interoperability endpoints

  • Direct secure messaging: ddehaan2229299@epic00.corewelldirect.org

Organizations & group practices 3

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.

Hospital & facility affiliations 11

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": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1376548107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-9600",
            "fax_number": "605-328-9620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27810 GRAND RIVER AVE",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483365916",
            "telephone_number": "248-516-1978"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7220 W 41st St",
            "address_purpose": "LOCATION",
            "city": "Sioux Falls",
            "state": "SD",
            "postal_code": "571066028",
            "country_code": "US",
            "telephone_number": "605-328-9600",
            "fax_number": "605-328-9620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEHAAN",
        "first_name": "DOUGLAS",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "1919",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301511075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5607207",
            "state": "SD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ddehaan3585@direct.sanfordhealth.org",
            "affiliation": "N",
            "address_1": "2601 S Ellis Rd",
            "city": "Sioux Falls",
            "state": "SD",
            "country_code": "US",
            "postal_code": "571067067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.