Daniel Mortensen, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

4301105002 Issued in MI

Practice address

602 Michigan Ave
Holland, MI 49423-4918

Phone

(616) 392-5141

NPI assigned

May 6, 2014

Last updated

Feb 2, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Emergency Medicine

Education

Michigan State University College of Human Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Holland Community HospitalGroup PAC ID 0446157291, 174 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Holland Community Hospital

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Holland, MI
  • NPI 1780888099
  Medicare reassignment Care Compare group NPD
• Epi PC

  • Emergency Medicine Physician
  • Holland, MI
  • NPI 1225082266
  Medicare reassignment NPD
• Holland Community Hospital

  dba Holland Hospital

  • General Acute Care Hospital
  • Holland, MI
  • NPI 1871672618
  NPD
• Holland Community Hospital

  • Family Medicine Physician
  • Hudsonville, MI
  • NPI 1952130585
  NPD

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

{
    "created_epoch": "1399334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485993600000",
    "number": "1447660931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1012",
            "city": "NEWAYGO",
            "state": "MI",
            "postal_code": "493371012",
            "telephone_number": "231-652-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 MICHIGAN AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234918",
            "telephone_number": "616-392-5141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTENSEN",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-06",
        "last_updated": "2017-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301105002",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301105002",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith Morley, LMSW
• Jennifer L Morrical, M.D.
• Sandra K Morris, M.A., LLP
• Gina Morrow
• Ronald L Morse, D.P.M.
• Lauren Ashley Mortensen, MD
• Sadie Morway, MS, AT, ATC, CSCS
• Rachel Mosier
• Carolyn Howe Mossing, PA-C
• Michael W Mott, MD

• Emergency Medicine Physician in Holland, MI
• Providers in Holland, MI by specialty
• Emergency Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.