Individual provider Active NPI

Daliya Khuon, MD

  • Pediatric Infectious Diseases Physician
  • Grand Rapids, MI
National Provider Identifier
1598909202
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X
License
4301107868 Issued in MI
Practice address
35 Michigan St NE
Suite 4150
Grand Rapids, MI 49503-2514
Phone
(616) 267-2300
Fax
(616) 267-2301
NPI assigned
Apr 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Infectious Diseases Physician 2080P0208X 4301107868 MI Primary

Addresses

Primary practice location

35 Michigan St NE
Suite 4150
Grand Rapids, MI 49503-2514

Mailing address

100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address dkhuon113261@epic00.shdirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/

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
I20150724011992 MI Practitioner - Pediatric MedicinePractitioner - Infectious Disease 4486890183 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Infectious Disease
Education
Northwestern University Feinberg Medical School, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560

100 Michigan St NE RM
280 Corewell Health Medical Group West
Grand Rapids, MI 49503-2560
Phone (616) 267-0115

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners Pediatric Infectious Diseases Current Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jul 27, 2015 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jul 27, 2015 Accepting new patients
Bronson Methodist Hospital CurrentSince Sep 27, 2021 Accepting new patients

Locations

35 Michigan St NE
Ste 4150
Grand Rapids, MI 49503
Phone (616) 267-2100

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

Interoperability endpoints

  • Direct secure messaging: dkhuon113261@epic00.corewelldirect.org

Organizations & group practices 4

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": "1240531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1598909202",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 MICHIGAN ST NE",
            "address_2": "SUITE 4150",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032514",
            "telephone_number": "616-267-2300",
            "fax_number": "616-267-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHUON",
        "first_name": "DALIYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-24",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "MI",
            "license": "4301107868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dkhuon113261@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "35 Michigan St NE",
            "address_2": "Suite 4150",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495032514",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "35 Michigan St NE",
            "address_2": "Suite 4150",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495032514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.