Dan Siegel Fogel, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6801057400 Issued in MI

Practice address

75 Sheldon Blvd SE
Suite 100 & 101
Grand Rapids, MI 49503-4224

Phone

(616) 391-2420

Fax

(616) 391-4425

NPI assigned

Oct 5, 2006

Last updated

Dec 19, 2013By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Claystone Clinical Associates PLCGroup PAC ID 1658387014, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Claystone Clinical Associates PLC

  • Psychiatry Physician
  • Grand Rapids, MI
  • NPI 1619927142
  Medicare reassignment Care Compare group NPD
• Claystone Clinical Associates PLC

  • Psychiatry Physician
  • Grand Rapids, MI
  • NPI 1336668698
  NPD (past)
• Life Guidance Services

  • Social Worker
  • Grand Rapids, MI
  • NPI 1336185032
  NPD (past)

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387411200000",
    "number": "1619063898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 SHELDON BLVD SE",
            "address_2": "SUITE 100 & 101",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034224",
            "telephone_number": "616-391-2420",
            "fax_number": "616-391-4425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGEL",
        "first_name": "DAN",
        "middle_name": "SIEGEL",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2013-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801057400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Flynn
• FMS Clyde Park South, LLC (Fresenius Kidney Care Clyde Park South)
• Hunter Logan Foco
• Kelsey Foco, LLMSW
• Aida S. Foerster, LLPC
• George C-C Fogg, MD, PHD
• Laura L. Fogle, D.D.S., M.S.
• Karla Anne Foisy
• Keith J Foisy, LLMSW
• September Foisy

• Social Worker in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2013; 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.