Individual provider Active NPI

Daniel John Legault, MD

  • Nephrology Physician
  • Grand Rapids, MI
National Provider Identifier
1649204892
Registry record updated Oct 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
DL056685 Issued in MI
Practice address
330 E Beltline Ave NE
Suite 100
Grand Rapids, MI 49506-1267
Phone
(616) 752-6235
Fax
(616) 752-6324
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X DL056685 MI Primary

Addresses

Primary practice location

330 E Beltline Ave NE
Suite 100
Grand Rapids, MI 49506-1267

Mailing address

330 E Beltline Ave NE
Suite 100
Grand Rapids, MI 49506-1267
Phone (616) 752-6235

Other identifiers 1

IdentifierTypeStateIssuer
3410503MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address daniel.legault@rawm.eclinicaldirectplus.com

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
I20040802001075 MI Practitioner - NephrologyPractitioner - Internal Medicine 3870564107 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
University of Michigan Medical School, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Mary's Health ServicesGroup PAC ID 4981500436, 175 clinicians
Renal Associates of West Michigan PCGroup PAC ID 2466348644, 20 clinicians

Practice addresses (Care Compare)

1000 Edison Ave NW
Christian Rest Home
Grand Rapids, MI 49504-3918
Phone (616) 453-2475

1010 Edison Ave NW
Edison Assisted Living Center
Grand Rapids, MI 49504-3918
Phone (616) 453-0581

200 Jefferson Ave SE
Grand Rapids, MI 49503-4502
Phone (616) 685-1835

330 E Beltline Ave NE
Suite 100
Grand Rapids, MI 49506-1267
Phone (616) 752-6235

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.16 of 100Reported as group
Quality
95.73
Improvement activities
40
Cost
75.12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DL056685MIMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners CurrentSince Jan 1, 2026 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jan 1, 2026 Accepting new patients
Saint Mary's Health Services CurrentSince Sep 1, 2021 Accepting new patients
Renal Associates of West Michigan PC Nephrology CurrentSince Oct 6, 1997 Accepting new patients
Rai Care Centers of Holland, LLC PastSince Oct 6, 1997 Accepting new patients
University Medical Diagnostic Associates, Inc. Nephrology Past Accepting new patients

Locations

310 Lafayette Ave SE
Grand Rapids, MI 49503
Phone (616) 685-3450

310 Lafayette Ave SE
Ste 410
Grand Rapids, MI 49503
Phone (616) 685-8200

330 E Beltline Ave NE
Ste 100
Grand Rapids, MI 49506
Phone (616) 752-6235

200 Jefferson Ave SE
Grand Rapids, MI 49503
Phone (616) 685-5000

275 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 267-7900

649 Hastings Ave
Holland, MI 49423
Phone (616) 392-3263

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

Interoperability endpoints

  • Direct secure messaging: dlegault35966@direct.acumenmd.com

Organizations & group practices 6

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.

Hospital & facility affiliations 6

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1649204892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 E BELTLINE AVE NE",
            "address_2": "SUITE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495061267",
            "telephone_number": "616-752-6235",
            "fax_number": "616-752-6324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 E BELTLINE AVE NE",
            "address_2": "SUITE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495061267",
            "telephone_number": "616-752-6235",
            "fax_number": "616-752-6324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGAULT",
        "first_name": "DANIEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MI",
            "license": "DL056685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3410503",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "daniel.legault@rawm.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "330 E Beltline Ave NE",
            "address_2": "Suite 100",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495061267",
            "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.