Individual provider Active NPI

Brian Haskin, MD

  • Internal Medicine Physician
  • Rockford, MI
National Provider Identifier
1437106648
Registry record updated Sep 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301059679 Issued in MI
Practice address
517 E Division St
Rockford, MI 49341-1376
Phone
(616) 974-4884
NPI assigned
May 31, 2006
Last updated
Sep 2, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301059679 MI Primary

Addresses

Primary practice location

517 E Division St
Rockford, MI 49341-1376

Mailing address

100 Michigan St NE
Mc845
Grand Rapids, MI 49503-2560

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
I20100108000084 MI Practitioner - Internal MedicinePractitioner - Pediatric Medicine 3971681917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
University of Michigan Medical School, 1992
Medicare assignment
May accept Medicare assignment
Group practices
Brookville Pediatric and Internal Medicine, PCGroup PAC ID 0446273510, 3 clinicians

Practice addresses (Care Compare)

8485 Algoma Ave NE
Rockford, MI 49341-8104
Phone (616) 863-6220

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301059679MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brookville Pediatric & Internal Medicine, PC Internal Medicine CurrentSince Jul 11, 2016 Accepting new patients
Michigan Medical Patient Care PastSince May 1, 2008 Accepting new patients

Locations

8485 Algoma Ave NE
Rockford, MI 49341
Phone (616) 863-6220

1200 56th St SW
Wyoming, MI 49509
Phone (616) 243-5707

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409616000000",
    "number": "1437106648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 E DIVISION ST",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493411376",
            "telephone_number": "616-974-4884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASKIN",
        "first_name": "BRIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2014-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301059679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, MI

Sources for this page

Verify at the official NPI Registry.