Individual provider Active NPI

Douglas A Winstanley, D.O.

  • MOHS-Micrographic Surgery Physician
  • Grandville, MI
National Provider Identifier
1609855402
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
5101015191 Issued in MI
Practice address
3434 Rivertown Point CT SW
Grandville, MI 49418-3076
Phone
(616) 257-3344
NPI assigned
Jan 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 5101015191 MI
MOHS-Micrographic Surgery Physician 207ND0101X 5101015191 MI Primary

Addresses

Primary practice location

3434 Rivertown Point CT SW
Grandville, MI 49418-3076

Mailing address

3434 Rivertown Point CT SW
Grandville, MI 49418-3076
Phone (616) 257-3344

Other practice location 1

3290 N Wellness Dr Ste 240
Holland, MI 49424-7261
Phone (616) 395-9379

Other practice location 2

6150 Northland Drive
Rockford, MI 49341
Phone (616) 942-9343

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address DAW1020@westmiderm.emadirect.md Health Information Exchange (HIE)

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
I20150608002777 MI Practitioner - Dermatology 4486877453 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jack a Dekkinga MD PCGroup PAC ID 3375538432, 20 clinicians

Practice addresses (Care Compare)

3290 N Wellness Dr
BLDG D Suite 240
Holland, MI 49424-7261
Phone (616) 395-9379

3434 Rivertown Point CT SW
Grandville, MI 49418-3076
Phone (616) 257-3344

Hospital & facility affiliations

  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision35
Removal of skin lesions198
Removal of skin cancer291
Removal or shaving of skin growth38
Skin biopsy58

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101015191MIMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jack a Dekkinga MD PC Dermatology CurrentSince Jul 1, 2015 Accepting new patients

Locations

4175 Parkway Place Dr SW
Ste 104
Grandville, MI 49418

4285 Parkway Place Dr SW
Grandville, MI 49418
Phone (616) 252-4300

3434 Rivertown Point Ct SW
Grandville, MI 49418
Phone (616) 257-3344

3290 N Wellness Dr
Ste 240
Holland, MI 49424
Phone (616) 395-9379

6150 Northland Dr NE
Rockford, MI 49341
Phone (616) 942-9343

2660 44th St SW
Ste 100
Wyoming, MI 49519
Phone (616) 974-9760

Interoperability endpoints

  • Direct secure messaging: daw1020@westmiderm.emadirect.md

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 2

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": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1609855402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3434 RIVERTOWN POINT CT SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494183076",
            "telephone_number": "616-257-3344",
            "fax_number": "616-257-1491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 RIVERTOWN POINT CT SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494183076",
            "telephone_number": "616-257-3344"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3290 N Wellness Dr Ste 240",
            "address_purpose": "LOCATION",
            "city": "Holland",
            "state": "MI",
            "postal_code": "494247261",
            "country_code": "US",
            "telephone_number": "616-395-9379",
            "fax_number": "616-820-1457",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6150 Northland Drive",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "MI",
            "postal_code": "49341",
            "country_code": "US",
            "telephone_number": "616-942-9343",
            "fax_number": "616-942-2538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WINSTANLEY",
        "first_name": "DOUGLAS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "5101015191",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "MI",
            "license": "5101015191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "DAW1020@westmiderm.emadirect.md",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "3434 Rivertown Point Ct SW",
            "city": "Grandville",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494183076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grandville, MI

Sources for this page

Verify at the official NPI Registry.