DR. DANIEL JOHN ROBERTSON M.D.
NPI 1578501573
Surgery - Pediatric Surgery in Grand Rapids, MI

Q: What is the provider's specialty?

The provider's specialty is Surgery with taxonomy code 2086S0120X and a focus in Pediatric Surgery.

Active since June 02, 2006PECOS Enrolled

330 BARCLAY AVE NE, SUITE 202, GRAND RAPIDS, MI 49503(616) 458-1722(616) 458-0061 Get Directions Write a Review

NPPES record last updated: October 11, 2007. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Dr. Daniel John Robertson M.d. NPPES

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

DR. DANIEL JOHN ROBERTSON M.D. (NPI 1578501573) is an individual pediatric surgery provider in Grand Rapids, Michigan, licensed in Michigan (DR087361) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1578501573

Entity TypeIndividualMale

Primary Taxonomy2086S0120X

Provider Legal NameDR. DANIEL JOHN ROBERTSONCredential: M.D.

Location Address330 BARCLAY AVE NE, SUITE 202Grand Rapids, MI 49503-2556

Mailing Address330 Barclay Ave Ne, Suite 202Grand Rapids, MI 49503-2556 · (616) 458-1722 · Fax (616) 458-0061

Phone(616) 458-1722

Fax(616) 458-0061

Sole ProprietorNo

Enumeration DateJune 2, 2006

Last NPPES UpdateOctober 11, 2007

✔ NPI 1578501573 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Pediatric SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code2086S0120X

License✔ Licensed in MI · DR087361

Definition

A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.

330 BARCLAY AVE NE, Grand Rapids, MI 49503

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Other Identifiers 3

OtherP00203119AL · Railroad Medicare

Medicare UPINH80609

Medicaid4868466MI

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. Daniel John Robertson M.d. 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.