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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. DAERYL DAVE ELGINCOLIN AMPONIN MD
NPI 1093419301
Emergency Medicine in Lanse, MI

Active since March 29, 2023PECOS Enrolled
18341 US HIGHWAY 41, LANSE, MI 49946(906) 524-3300 Get Directions Write a Review

NPPES record last updated: June 30, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Daeryl Dave Elgincolin Amponin Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DAERYL DAVE ELGINCOLIN AMPONIN MD (NPI 1093419301) is an individual emergency medicine provider in Lanse, Michigan, licensed in Michigan (4351050910) and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS and maintains a secondary practice location in Southfield.

NPPES Registry Identity

NPI1093419301
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameDR. DAERYL DAVE ELGINCOLIN AMPONINCredential: MD
Location Address18341 US HIGHWAY 41Lanse, MI 49946-8024
Mailing Address18341 Us Highway 41Lanse, MI 49946-8024 · (906) 524-3300
Phone(906) 524-3300
Sole ProprietorNo
Enumeration DateMarch 29, 2023
Last NPPES UpdateJune 30, 2026
NPPES CertifiedJune 30, 2026
✔ NPI 1093419301 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in MI · 4351050910
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
18341 US HIGHWAY 41, Lanse, MI 49946
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Secondary Practice Location 1

Location 116001 W 9 Mile RdSouthfield, MI 48075-4818 · Phone (248) 849-5664

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Daeryl Dave Elgincolin Amponin Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49946 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.09 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PEYTON ELIZABETH HOLMA PA
Physician Assistant
18341 US HIGHWAY 41
LANSE, MI 49946
Baraga County (906) 524-3300
KATIE KOLBUS
Speech-Language Pathologist
18341 US HIGHWAY 41
LANSE, MI 49946
Baraga County (906) 524-3445
MRS. SHANNON RAE DUFEK PA-C
Physician Assistant
18341 US HIGHWAY 41
LANSE, MI 49946
Baraga County (906) 525-3300
NANCY L HERCK PA-C
Physician Assistant
18341 US HIGHWAY 41
LANSE, MI 49946
Baraga County (906) 524-6118
JEFFREY S DAUPHINAIS NP
Nurse Practitioner (Family)
18341 US HIGHWAY 41
LANSE, MI 49946
Baraga County (906) 524-6118
TRISTA BARRON
Occupational Therapist
18341 US HIGHWAY 41
LANSE, MI 49946
Baraga County (906) 524-3445
DR. TODD V INGRAM M.D.
Family Medicine
18341 US HIGHWAY 41
LANSE, MI 49946
Baraga County (906) 524-6118
MRS. ANGELA MARIE GRAY MS, LPC
Counselor
18341 US HIGHWAY 41
LANSE, MI 49946
Baraga County (906) 524-3300

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Daeryl Dave Amponin's NPI number?

The NPI number for Daeryl Dave Amponin is 1093419301. It was assigned to this individual provider in the NPPES registry on March 29, 2023.

Where is Daeryl Dave Amponin located?

Daeryl Dave Amponin practices at 18341 Us Highway 41, Lanse, MI 49946. The listed phone number is (906) 524-3300.

What is Daeryl Dave Amponin's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Daeryl Dave Amponin enrolled in Medicare?

Yes. Daeryl Dave Amponin is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Daeryl Dave Amponin was last updated on June 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 37 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.