DR. JACK DOUGLAS DEHAAN MD
NPI 1851975429
Emergency Medicine in Grand Blanc, MI

Q: What is Jack Dehaan's NPI number?

The NPI number for Jack Dehaan is 1851975429. It was assigned to this individual provider in the NPPES registry on May 10, 2021.

Q: What is Jack Dehaan's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Jack Dehaan was last updated on September 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.

Active since May 10, 2021PECOS EnrolledAccepts Medicare Assignment

1 GENESYS PKWY, GRAND BLANC, MI 48439(810) 606-6372(810) 606-5990 Get Directions Write a Review

NPPES record last updated: September 3, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 3, 2025, May 10, 2021 (2 updates tracked since 2021).

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About Dr. Jack Douglas Dehaan Md NPPES

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

DR. JACK DOUGLAS DEHAAN MD (NPI 1851975429) is an individual emergency medicine provider in Grand Blanc, Michigan, licensed in Indiana (01096929A) and active in the NPI registry since May 2021. He is enrolled in Medicare PECOS, is affiliated with Saint Joseph Regional Medical Center, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1851975429

Entity TypeIndividualMale

Primary Taxonomy207P00000X

Provider Legal NameDR. JACK DOUGLAS DEHAANCredential: MD

Location Address1 GENESYS PKWYGrand Blanc, MI 48439-8065

Mailing Address1 Genesys PkwyGrand Blanc, MI 48439-8065 · (810) 606-6372 · Fax (810) 606-5990

Phone(810) 606-6372

Fax(810) 606-5990

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateMay 10, 2021

Last NPPES UpdateSeptember 3, 20252 updates tracked since enumeration

NPPES CertifiedSeptember 3, 2025

✔ NPI 1851975429 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207P00000X

Licenses✔ Licensed in IN · 01096929A✔ Licensed in MI · 4351048260

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.

1 GENESYS PKWY, Grand Blanc, MI 48439

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Jack Douglas Dehaan 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 ID4486058062

PECOS Enrollment IDI20250712000799

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 Reassignments

Medicare enrollment records show Jack Dehaan reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Caberfae Emergency Group, P.C.

128 mi

Emergency Medicine

400 HOBART ST
Cadillac, MI 49601

Reassigned Medicare billing, Michigan enrollment
Medicare enrollment name: Caberfae Emergency Group PC
92 clinicians in this Medicare group

NPI 1447932504 (231) 876-7200

Cep America LLC

145 mi

Emergency Medicine

200 HIGH PARK AVE
Goshen, IN 46526

Reassigned Medicare billing, Indiana enrollment
598 clinicians in this Medicare group

NPI 1154125698 (574) 364-2608

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

Hospital Affiliations CMS Care Compare 2

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

Saint Joseph Regional Medical Center

Acute Care Hospitals · Mishawaka, IN

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150012

Location5215 Holy Cross PkwyMishawaka, IN 46545 · St. Joseph County

Emergency services Birthing friendly

Saint Joseph Regional Medical Center - Plymouth

Acute Care Hospitals · Plymouth, IN

2/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number150076

Location1915 Lake AvePlymouth, IN 46563 · Marshall County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48439 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.

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