NPIMap

Individual provider Active NPI

Alexander Paul Dehaan, D.O.

  • Urology Physician
  • Wyoming, MI
National Provider Identifier
1932324522
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
5101016415 Issued in MI
Practice address
2093 Health Dr SW Ste 202
Wyoming, MI 49519-9691
Phone
(616) 459-4171
Fax
(616) 531-7547
NPI assigned
Apr 17, 2007
Last updated
Jan 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 5101016415 MI Primary

Addresses

Primary practice location

2093 Health Dr SW Ste 202
Wyoming, MI 49519-9691

Mailing address

20952 E 12 Mile Rd Ste 200
Saint Clair Shores, MI 48081-3203
Phone (586) 771-4820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110915000863 MI Practitioner - Urology 5092986455 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Michigan State University College of Osteopathic Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Michigan Institute of Urology PCGroup PAC ID 1052223492, 82 clinicians
Metropolitan HospitalGroup PAC ID 5597651836, 421 clinicians

Practice addresses (Care Compare)

25 Michigan St NE
Suite 3300
Grand Rapids, MI 49503-2558
Phone (616) 459-4171

781 36TH St SE
Metro HLTH Comm Clinic
Wyoming, MI 49548-2319
Phone (616) 252-4100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101016415MIMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Hospital Urology CurrentSince Nov 2, 2011 Accepting new patients
Alliance Physician Services of Michigan, P.C. Urology CurrentSince Nov 1, 2023 Accepting new patients
Alliance Physician Services of Michigan, P.C. Urology CurrentSince Aug 15, 2011 Accepting new patients
Metropolitan Hospital CurrentSince Nov 2, 2011 Accepting new patients
Michigan Institute of Urology PC Urology CurrentSince Nov 1, 2023 Accepting new patients

Locations

4150 S River Rd
Ste C
East China, MI 48054
Phone (576) 771-4820

25 Michigan St NE
Ste 3300
Grand Rapids, MI 49503
Phone 6164594171116

4070 Lake Dr SE
Ste L101
Grand Rapids, MI 49546
Phone (616) 301-7953

20952 E 12 Mile Rd
Ste 200
St Clr Shores, MI 48081
Phone (586) 771-4820

2093 Health Dr SW
Ste 202
Wyoming, MI 49519
Phone (586) 771-4820

781 36th St SE
Wyoming, MI 49548
Phone (616) 252-4100

Interoperability endpoints

  • Direct secure messaging: adehaan535@direct.metrohealth.net

Organizations & group practices 5

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": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1932324522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20952 E 12 MILE RD STE 200",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813203",
            "telephone_number": "586-771-4820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2093 HEALTH DR SW STE 202",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199691",
            "telephone_number": "616-459-4171",
            "fax_number": "616-531-7547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHAAN",
        "first_name": "ALEXANDER",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2024-01-30",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "5101016415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

Verify at the official NPI Registry.