NPIMap

Individual provider Active NPI

Dean M Havlik, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Grand Junction, CO
National Provider Identifier
1508857442
Registry record updated Feb 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
39245 Issued in CO
Practice address
2351 G Road
Community Hospital
Grand Junction, CO 81505
Phone
(970) 644-3283
NPI assigned
Oct 31, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 39245 CO Primary

Addresses

Primary practice location

2351 G Road
Community Hospital
Grand Junction, CO 81505

Mailing address

PO Box 4235
Grand Junction, CO 81502
Phone (970) 256-6463

Other identifiers 3

IdentifierTypeStateIssuer
T0328MedicaidUT
06629733MedicaidCO
220030307OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20110131001017 CO Practitioner - Pathology 3173702503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Medical College of Pennsylvania, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2351 G Rd
Grand Junction, CO 81505-9641
Phone (970) 644-3283

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual
Quality
50
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39245COMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Pathology Group PC Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2001 Accepting new patients

Locations

2021 N 12th St
Grand Junction, CO 81501
Phone (970) 242-0920

2351 G Rd
Grand Junction, CO 81505
Phone (970) 242-0920

1308 E Common St
Ste 205
New Braunfels, TX 78130

Organizations & group practices 1

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.

Hospital & facility affiliations 10

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": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580688000000",
    "number": "1508857442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4235",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "81502",
            "telephone_number": "970-256-6463",
            "fax_number": "970-256-6512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2351 G ROAD",
            "address_2": "COMMUNITY HOSPITAL",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "81505",
            "telephone_number": "970-644-3283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVLIK",
        "first_name": "DEAN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CO",
            "license": "39245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T0328",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06629733",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "220030307",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.