Active NPI
David Chester Haller, D.O.
- Emergency Medicine Physician
- Grand Rapids, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 5101020022
- Practice address
- 80 68TH St SE
Grand Rapids, MI 49548 - Phone
- (616) 391-8242
- Fax
- (616) 391-8317
- NPI assigned
- Jun 19, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 20A16525 | CA | |
| Emergency Medicine Physician | 207P00000X | 5101020022 | MI | Primary |
Addresses
Primary practice location
80 68TH St SE
Grand Rapids, MI 49548
Mailing address
100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560
Phone (616) 391-8242
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538422159 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Michigan State University College of Osteopathic Medicine, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
200 Mission Blvd
Jackson, CA 95642-2564
Phone (209) 223-7500
Hospital & facility affiliations
- Sutter Roseville Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 96.69 of 100
- Quality
- 90
- Improvement activities
- 40
- Cost
- 78.43
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A16525 | CA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ascension Borgess Hospital | Current | Accepting new patients | |
| Cep America - California | Emergency Medicine | Current | Accepting new patients |
| Ascension Borgess Hospital | Current | Accepting new patients | |
| Cep America - California | Emergency Medicine | Current | Accepting new patients |
| Sound Physicians Emergency Medicine of Michigan, PLLC | Emergency Medicine | Current | Accepting new patients |
| Hometown Urgent Care of Michigan, P.C. | Current | Accepting new patients | |
| Cep America-California | Emergency Medicine | Current | Accepting new patients |
Locations
2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777
1650 Creekside Dr
Folsom, CA 95630
Phone (916) 983-7400
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423
4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156
1 Medical Plaza Dr
Roseville, CA 95661
Phone (916) 781-1000
4001 J St
Sacramento, CA 95819
Phone (916) 453-4037
1501 W Chisholm St
Alpena, MI 49707
Phone (989) 356-7000
420 W High St
Dowagiac, MI 49047
Phone (269) 782-8681
1634 Gull Rd
Kalamazoo, MI 49048
Phone (269) 903-2835
1521 Gull Rd
Kalamazoo, MI 49048
Phone (269) 226-5165
411 Naomi St
Plainwell, MI 49080
Phone (269) 685-0700
Interoperability endpoints
- dhaller424427@hisp.ehr.sutterhealth.org
Organizations & group practices 8
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.
-
- Emergency Medicine Physician
- San Francisco, CA
- NPI 1023063542
-
- General Acute Care Hospital
- Kalamazoo, MI
- NPI 1568416311
-
- Emergency Medicine Physician
- Adrian, MI
- NPI 1568913473
-
- Urgent Care Clinic/Center
- Huber Heights, OH
- NPI 1790030385
MI
-
- Diagnostic Radiology Physician
- Kalamazoo, MI
- NPI 1518753441
-
- Clinical Medical Laboratory
- Kalamazoo, MI
- NPI 1891469631
-
- Emergency Medicine Physician
- Los Banos, CA
- NPI 1699073700
-
- Emergency Medicine Physician
- Murrieta, CA
- NPI 1588552848
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Roseville, CA
- NPI 1356390264
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530489600000",
"number": "1538422159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 MICHIGAN ST NE",
"address_2": "MC 845",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495032560",
"telephone_number": "616-391-8242",
"fax_number": "616-391-8317"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 68TH ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "49548",
"telephone_number": "616-391-8242",
"fax_number": "616-391-8317"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALLER",
"first_name": "DAVID",
"middle_name": "CHESTER",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-06-19",
"last_updated": "2018-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CA",
"license": "20A16525",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MI",
"license": "5101020022",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1538422159",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2018; 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.