Active NPI
Daniel Glen Vickers, D.O.
- Diagnostic Radiology Physician
- East Lansing, MI
National Provider Identifier
1902007644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 5101016856
- Practice address
- 138 Service Rd Ste D100
East Lansing, MI 48824-1313 - Phone
- (517) 353-5053
- NPI assigned
- May 30, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 5101016856 | MI | Primary |
Addresses
Primary practice location
138 Service Rd Ste D100
East Lansing, MI 48824-1313
Mailing address
605 W Western Ave
Muskegon, MI 49440-1080
Phone (231) 722-6005
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902007644 | Medicaid | MI |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Michigan State University College of Osteopathic Medicine, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1700 Clinton St
Muskegon, MI 49442-5502
Phone (231) 728-4948
2511 Shears Crossing CT NE
Grand Rapids, MI 49525-9328
Phone (281) 742-0469
375 Pine St
Fruitport, MI 49415-9638
Phone (972) 492-3846
3863 Honors Way
Howell, MI 48843-7494
Phone (855) 504-4544
Hospital & facility affiliations
- Trinity Health Muskegon Hospital
- Duncan Regional Hospital, Inc
- Mercy Health Lakeshore Campus
- Paris Regional Medical Center
- Community Hospital, LLC
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 97.54
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101016856 | MI | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Star MRI LP | Current | Accepting new patients | |
| Eagle Partners, PLLC | Diagnostic Radiology | Current | Accepting new patients |
| Gateway Diagnostic Imaging Sherman, LLC | Current | Accepting new patients | |
| Radiology Muskegon PC | Diagnostic Radiology | Current | Accepting new patients |
| North Star FP, LP | Current | Accepting new patients | |
| North Star GV, LP | Current | Accepting new patients | |
| North Star MCD, LLC | Current | Accepting new patients | |
| North Star Diagnostic Imaging, LLC | Current | Accepting new patients | |
| North Star NPT LP | Current | Accepting new patients | |
| North Star CN, LP | Current | Accepting new patients | |
| North Star MRI of Frisco LP | Current | Accepting new patients | |
| North Star FM, LP | Current | Accepting new patients | |
| North Star Plano Parkway, LP | Past | Accepting new patients | |
| Michigan State University | Past | Accepting new patients |
Locations
1700 Clinton St
Muskegon, MI 49442
Phone (231) 726-3511
1500 E Sherman Blvd
Muskegon, MI 49444
Phone (231) 672-3027
3535 Park St
Ste 105
Norton Shores, MI 49444
Phone (231) 739-7191
Organizations & group practices 15
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.
-
- Diagnostic Radiology Physician
- Muskegon, MI
- NPI 1841208071
-
- Diagnostic Radiology Physician
- Shenandoah, TX
- NPI 1538107875
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Shelby, MI
- NPI 1285662981
-
- General Acute Care Hospital
- Muskegon, MI
- NPI 1831132133
-
- General Acute Care Hospital
- Oklahoma City, OK
- NPI 1275593337
-
- Rural Acute Care Hospital
- Duncan, OK
- NPI 1851396394
-
- General Acute Care Hospital
- Paris, TX
- NPI 1063411767
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460419200000",
"number": "1902007644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "605 W WESTERN AVE",
"city": "MUSKEGON",
"state": "MI",
"postal_code": "494401080",
"telephone_number": "231-722-6005",
"fax_number": "231-726-2804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "138 SERVICE RD STE D100",
"city": "EAST LANSING",
"state": "MI",
"postal_code": "488241313",
"telephone_number": "517-353-5053"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VICKERS",
"first_name": "DANIEL",
"middle_name": "GLEN",
"name_prefix": "Mr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-30",
"last_updated": "2016-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MI",
"license": "5101016856",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1902007644",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in East Lansing, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2016; 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.