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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.

DANIEL HARRY HAVLICHEK III MD
NPI 1679034383
Internal Medicine - Gastroenterology in Grand Rapids, MI

Active since March 26, 2019PECOS Enrolled
4100 LAKE DR SE, GRAND RAPIDS, MI 49546(616) 267-7414 Get Directions Write a Review

NPPES record last updated: August 24, 2026. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Aug 24, 2026, Aug 25, 2020, Jul 15, 2020 (3 updates tracked since 2020).

About Daniel Harry Havlichek Iii Md NPPES

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

DANIEL HARRY HAVLICHEK III MD (NPI 1679034383) is an individual gastroenterology provider in Grand Rapids, Michigan, licensed in Michigan (4301518207) and active in the NPI registry since March 2019. He is enrolled in Medicare PECOS, is affiliated with Loyola Gottlieb Memorial Hospital, and is a graduate of Michigan State University College Of Human Medicine (2019).

NPPES Registry Identity

NPI1679034383
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameDANIEL HARRY HAVLICHEK IIICredential: MD
Location Address4100 LAKE DR SEGrand Rapids, MI 49546-8292
Mailing Address100 Michigan St Ne, Mc 845Grand Rapids, MI 49503-2560
Phone(616) 267-7414
Sole ProprietorNo
Medical School CMSMichigan State University College Of Human MedicineGraduated 2019
Enumeration DateMarch 26, 2019
Last NPPES UpdateAugust 24, 20263 updates tracked since enumeration
NPPES CertifiedAugust 24, 2026
✔ NPI 1679034383 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License✔ Licensed in MI · 4301518207
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
4100 LAKE DR SE, Grand Rapids, MI 49546
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Daniel Harry Havlichek Iii Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5991039539
PECOS Enrollment IDI20250508001986
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.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Loyola Gottlieb Memorial Hospital

Acute Care Hospitals · Melrose Park, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140008
Location701 West North AveMelrose Park, IL 60160 · Cook County
Emergency services

Loyola University Medical Center

Acute Care Hospitals · Maywood, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140276
Location2160 S 1st AvenueMaywood, IL 60153 · Cook County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49546 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
$126.15 typical visit price
range $54.34 – $166.68
Typical copayment $31.53 (range $13.58 – $41.67)
Most-billed visit code 99204
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.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier15 claims15 services$13.08 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

TELLA KATARINA MINKKINEN PT
Physical Therapist
4100 LAKE DR SE, SUITE 305
GRAND RAPIDS, MI 49546
Kent County (616) 285-1377
RANDALL SCOTT MEISNER MD
Internal Medicine (Gastroenterology)
4100 LAKE DR SE, SUITE 205
GRAND RAPIDS, MI 49546
Kent County (616) 267-7414
DR. MARYKAY LEHMAN M.D.
Internal Medicine (Pulmonary Disease)
4100 LAKE DR SE, SUITE 200
GRAND RAPIDS, MI 49546
Kent County (616) 949-8244
GUSTAVO CUMBO-NACHELI
Internal Medicine (Pulmonary Disease)
4100 LAKE DR SE, SUITE 200
GRAND RAPIDS, MI 49546
Kent County (616) 267-8244
JANET DOMINOWSKI RD
Dietitian, Registered
4100 LAKE DR SE, SUITE 200
GRAND RAPIDS, MI 49546
Kent County (616) 267-8950
WALTER M BRAUNOHLER M.D.
Orthopaedic Surgery
4100 LAKE DR SE, SUITE 300
GRAND RAPIDS, MI 49546
Kent County (616) 267-8860
JILL C THORPE PA-C
Physician Assistant
4100 LAKE DR SE, SUITE 205
GRAND RAPIDS, MI 49546
Kent County (616) 774-2414
PATRICIA BEGGS AT, ATC
Specialist/Technologist (Athletic Trainer)
4100 LAKE DR SE, SUITE 300
GRAND RAPIDS, MI 49546
Kent County (616) 267-8565

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 Daniel Havlichek's NPI number?

The NPI number for Daniel Havlichek is 1679034383. It was assigned to this individual provider in the NPPES registry on March 26, 2019.

Where is Daniel Havlichek located?

Daniel Havlichek practices at 4100 Lake Dr SE, Grand Rapids, MI 49546. The listed phone number is (616) 267-7414.

What is Daniel Havlichek's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Daniel Havlichek enrolled in Medicare?

Yes. Daniel Havlichek is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Daniel Havlichek affiliated with any hospitals?

According to CMS data, Daniel Havlichek is affiliated with Loyola Gottlieb Memorial Hospital and Loyola University Medical Center.

When was this NPI record last updated?

The NPPES record for Daniel Havlichek was last updated on August 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.