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JOHN W KAVANAUGH JR. MD
NPI 1609858844
Pediatrics in Paw Paw, MI

Active since November 15, 2005PECOS Enrolled
451 HEALTH PKWY, SUITE E, PAW PAW, MI 49079(269) 655-3090(269) 655-0763 Get Directions Write a Review

NPPES record last updated: October 16, 2014. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About John W Kavanaugh Jr. Md NPPES

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

JOHN W KAVANAUGH JR. MD (NPI 1609858844) is an individual pediatrics provider in Paw Paw, Michigan, licensed in Michigan (4301405215) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1609858844
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameJOHN W KAVANAUGH JR.Credential: MD
Location Address451 HEALTH PKWY, SUITE EPaw Paw, MI 49079-8242
Mailing Address451 Health Pkwy, Suite EPaw Paw, MI 49079-8242 · (269) 655-3090 · Fax (269) 655-0763
Phone(269) 655-3090
Fax(269) 655-0763
Sole ProprietorNo
Enumeration DateNovember 15, 2005
Last NPPES UpdateOctober 16, 2014
✔ NPI 1609858844 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in MI · 4301405215
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
451 HEALTH PKWY, Paw Paw, MI 49079
Open in Google Maps ↗

Other Identifiers 3

Other238601MI · Medicare Rural Health Clinic Number
Medicare UPINF97545
Medicaid4938480MI

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

John W Kavanaugh Jr. 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.

Medicare Billing Reassignment

Medicare enrollment records show John Kavanaugh reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Bronson Lakeview Hospital
3.1 mi
Internal Medicine
451 HEALTH PKWY
Paw Paw, MI 49079
  • Reassigned Medicare billing, Michigan enrollment
  • 251 clinicians in this Medicare group
NPI 1235131137 (269) 657-2550

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49079 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.

PAMELA NELSON M.D.
Family Medicine
451 HEALTH PKWY, SUITE B
PAW PAW, MI 49079
Van Buren County (269) 655-3065
ERIN AERTS
Physical Therapist
451 HEALTH PKWY
PAW PAW, MI 49079
Van Buren County (269) 657-8300
DR. TODD SUPER PHARM.D., BCPS
Pharmacist (Ambulatory Care)
451 HEALTH PKWY
PAW PAW, MI 49079
Van Buren County (269) 655-1735
KATHLEEN WESTRA
Occupational Therapist
451 HEALTH PKWY
PAW PAW, MI 49079
Van Buren County (269) 657-8300
PIOTR JAN MIETUSIEWICZ PHYSICAL THERAPIST
Physical Therapist
451 HEALTH PKWY
PAW PAW, MI 49079
Van Buren County (269) 657-8300
DR. LYNN JAMES KERN M.D.
Obstetrics & Gynecology
451 HEALTH PKWY, BOX 89
PAW PAW, MI 49079
Van Buren County (269) 655-3070
DR. ZEBI NAZ MD
Family Medicine
451 HEALTH PKWY, SUITE A
PAW PAW, MI 49079
Van Buren County (269) 657-2550
KINJU DUDHIA PT
Physical Therapist
451 HEALTH PKWY
PAW PAW, MI 49079
Van Buren County (269) 657-1490

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 John Kavanaugh's NPI number?

The NPI number for John Kavanaugh is 1609858844. It was assigned to this individual provider in the NPPES registry on November 15, 2005.

Where is John Kavanaugh located?

John Kavanaugh practices at 451 Health Pkwy Suite E, Paw Paw, MI 49079. The listed phone number is (269) 655-3090.

What is John Kavanaugh's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is John Kavanaugh enrolled in Medicare?

Yes. John Kavanaugh is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for John Kavanaugh's services?

According to the CMS Revalidation Reassignment List (October 2026 release), John Kavanaugh reassigns Medicare benefits to Bronson Lakeview Hospital (Paw Paw, MI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for John Kavanaugh's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for John Kavanaugh was last updated on October 16, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years 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.