Individual provider Active NPI

Daniel P Makande, MD

  • Emergency Medicine Physician
  • Kalamazoo, MI
National Provider Identifier
1447279989
Registry record updated Dec 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4301043996 Issued in MI
Practice address
6565 W Main St
Kalamazoo, MI 49009-6114
Phone
(269) 375-0459
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301043996 MI Primary
Internal Medicine Physician 207R00000X 4301043996 MI

Addresses

Primary practice location

6565 W Main St
Kalamazoo, MI 49009-6114

Mailing address

6565 West Main Street
Kalamazoo, MI 49009-9701
Phone (269) 375-0400

Other practice location 1

7901 Angling Rd
Portage, MI 49024-0714
Phone (269) 324-8405

Other identifiers 1

IdentifierTypeStateIssuer
4099370MedicaidMI

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
I20090122000377 MI Practitioner - Emergency MedicinePractitioner - Internal Medicine 7810051604 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301043996MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Borgess Hospital CurrentSince Nov 28, 2021 Accepting new patients
Ascension Borgess Hospital Current Accepting new patients
Promed Healthcare CurrentSince Nov 28, 2021 Accepting new patients
Ascension Medical Group Promed Internal Medicine CurrentSince Nov 28, 2021 Accepting new patients
Ascension Borgess Hospital CurrentSince Nov 28, 2021 Accepting new patients

Locations

6565 W Main St
Kalamazoo, MI 49009
Phone (269) 375-0400

1521 Gull Rd
Kalamazoo, MI 49048
Phone (269) 226-5165

7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405

955 S Bailey Ave
South Haven, MI 49090
Phone (269) 637-5271

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1447279989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6565 WEST MAIN STREET",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490099701",
            "telephone_number": "269-375-0400",
            "fax_number": "269-492-0660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6565 W MAIN ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490096114",
            "telephone_number": "269-375-0459"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7901 Angling Rd",
            "address_purpose": "LOCATION",
            "city": "Portage",
            "state": "MI",
            "postal_code": "490240714",
            "country_code": "US",
            "telephone_number": "269-324-8405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAKANDE",
        "first_name": "DANIEL",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301043996",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301043996",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4099370",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.