DR. DAVID JAMES RAWLINSON D.O.
NPI 1699086140
Ophthalmology in Muskegon, MI

Active since June 30, 2010PECOS EnrolledAccepts Medicare Assignment
74.46/100
CMS Quality Rating
1266 E SHERMAN BLVD, MUSKEGON, MI 49444(231) 739-9009 Get Directions Write a Review

NPPES record last updated: September 22, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 22, 2022, Oct 12, 2020 (2 updates tracked since 2020).

About Dr. David James Rawlinson D.o. NPPES

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

DR. DAVID JAMES RAWLINSON D.O. (NPI 1699086140) is an individual ophthalmology provider in Muskegon, Michigan, licensed in Michigan (5101018592) and active in the NPI registry since June 2010. He is enrolled in Medicare PECOS, is affiliated with Trinity Health Muskegon Hospital, and is a graduate of Michigan State University College Of Human Medicine (2014).

NPPES Registry Identity

NPI1699086140
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameDR. DAVID JAMES RAWLINSONCredential: D.O.
Location Address1266 E SHERMAN BLVDMuskegon, MI 49444-1847
Mailing Address1266 E Sherman BlvdMuskegon, MI 49444-1847 · (231) 739-9009
Sole ProprietorYes
Medical School CMSMichigan State University College Of Human MedicineGraduated 2014
Enumeration DateJune 30, 2010
Last NPPES UpdateSeptember 22, 20222 updates tracked since enumeration
NPPES CertifiedSeptember 22, 2022
NPI 1699086140 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License Licensed in MI · 5101018592
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
1266 E SHERMAN BLVD, Muskegon, MI 49444

Accepted Insurance

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

Dr. David James Rawlinson D.o. 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 ID1456571736
PECOS Enrollment IDI20160616001512
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.

Areas of Expertise CMS Part B claims 14

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
497 services429 patients
Measurement of corneal curvature and depth of eye 92136
This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.
346 services231 patients
Removal of cataract with insertion of prosthetic lens 66984
This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.
308 services179 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
160 services160 patients
Exam of visual field with extended testing 92083
An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
126 services125 patients
Imaging of optic nerve 92133
Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
112 services111 patients

Hospital Affiliations CMS Care Compare

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

Trinity Health Muskegon Hospital

Acute Care Hospitals · Muskegon, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230066
Location1500 E Sherman BlvdMuskegon, MI 49441 · Muskegon County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49444 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
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

74.46/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality98.49
Promoting Interoperability100
Improvement Activities40
Cost16.37

Other Providers at the Same Location NPPES 17

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

Ophthalmology
1266 E SHERMAN BLVD
MUSKEGON, MI 49444
Eyewear Supplier
1266 E SHERMAN BLVD
MUSKEGON, MI 49444
Ophthalmology
1266 E SHERMAN BLVD
MUSKEGON, MI 49444
Ophthalmology
1266 E SHERMAN BLVD
MUSKEGON, MI 49444
Optometrist
1266 E SHERMAN BLVD
MUSKEGON, MI 49444
Ophthalmology
1266 E SHERMAN BLVD
MUSKEGON, MI 49444
Durable Medical Equipment & Medical Supplies
1266 E SHERMAN BLVD
MUSKEGON, MI 49444
Optometrist
1266 E SHERMAN BLVD
MUSKEGON, MI 49444

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 David Rawlinson's NPI number?

The NPI number for David Rawlinson is 1699086140. It was assigned to this individual provider in the NPPES registry on June 30, 2010.

Where is David Rawlinson located?

David Rawlinson practices at 1266 E Sherman Blvd, Muskegon, MI 49444. The listed phone number is (231) 739-9009.

What is David Rawlinson's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is David Rawlinson enrolled in Medicare?

Yes. David Rawlinson 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.

What insurance does David Rawlinson accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 7 other insurers list David Rawlinson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is David Rawlinson affiliated with any hospitals?

According to CMS data, David Rawlinson is affiliated with Trinity Health Muskegon Hospital.

When was this NPI record last updated?

The NPPES record for David Rawlinson was last updated on September 22, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.