Individual provider Active NPI

Dante Gascon, MD

  • Family Medicine Physician
  • Wyoming, MI
National Provider Identifier
1912928276
Registry record updated Feb 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DG076330 Issued in MI
Practice address
5838 Metro Way SW
Wyoming, MI 49519-9619
Phone
(616) 249-5300
NPI assigned
Jul 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DG076330 MI Primary

Addresses

Primary practice location

5838 Metro Way SW
Wyoming, MI 49519-9619

Mailing address

5838 Metro Way
Wyoming, MI 49519
Phone (616) 249-5300

Other identifiers 1

IdentifierTypeStateIssuer
4712062MedicaidMI

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
I20250508002287 MI Order and Referring Only - Family PracticePractitioner - Family Practice 6204881758

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DG076330MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Battle Creek Vamc CurrentSince Feb 16, 2020 Accepting new patients

Locations

5838 Metro Way SW
Wyoming, MI 49519
Phone (616) 249-5300

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.

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1912928276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5838 METRO WAY",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "49519",
            "telephone_number": "616-249-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5838 METRO WAY SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199619",
            "telephone_number": "616-249-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASCON",
        "first_name": "DANTE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-22",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "DG076330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4712062",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

Verify at the official NPI Registry.