Dr Jack Douglas Dehaan, MD in Grand Blanc, MI

Dr Jack Douglas Dehaan, MD is a medicare enrolled "Emergency Medicine" physician in Grand Blanc, Michigan. His current practice location is 1 Genesys Pkwy, Grand Blanc, Michigan. You can reach out to his office (for appointments etc.) via phone at (810) 606-6372.

Dr Jack Douglas Dehaan is licensed to practice in Indiana (license number 01096929A) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1851975429.

Contact Information

	Dr Jack Douglas Dehaan, MD
	1 Genesys Pkwy, Grand Blanc, MI 48439-8065
	(810) 606-6372
	(810) 606-5990

Map and Direction

Physician's Profile

Full Name	Dr Jack Douglas Dehaan
Gender	Male
Speciality	Emergency Medicine
Location	1 Genesys Pkwy, Grand Blanc, Michigan
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1851975429
Provider Enumeration Date: 05/10/2021
Last Update Date: 09/03/2025

Medicare PECOS Information:

PECOS PAC ID: 4486058062
Enrollment ID: I20250221001673

Medical Identifiers

Medical identifiers for Dr Jack Douglas Dehaan such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1851975429	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207P00000X	Emergency Medicine	4351048260 (Michigan)	Secondary
207P00000X	Emergency Medicine	01096929A (Indiana)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Jack Douglas Dehaan allows following entities to bill medicare on his behalf.

Entity Name	Caberfae Emergency Group Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1447932504 PECOS PAC ID: 4082069232 Enrollment ID: O20231009002608

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jack Douglas Dehaan is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Jack Douglas Dehaan, MD 1 Genesys Pkwy, Grand Blanc, MI 48439-8065 Ph: (810) 606-6372	Dr Jack Douglas Dehaan, MD 1 Genesys Pkwy, Grand Blanc, MI 48439-8065 Ph: (810) 606-6372

Reviews and Comments

Emergency Medicine Doctors in Grand Blanc, MI

Dr. Tara Stone, MD, MPH Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1 Genesys Pkwy, Grand Blanc, MI 48439 Phone: 810-606-5000
Michael Briggs, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1 Genesys Pkwy, Grand Blanc, MI 48439 Phone: 810-606-6137
Alison Marie Ralston, Emergency Medicine Medicare: May Accept Medicare Assignments Practice Location: 1 Genesys Pkwy, Grand Blanc, MI 48439 Phone: 810-606-6372
Brian T West, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1 Genesys Pkwy, Grand Blanc, MI 48439 Phone: 810-606-6137
Dr. Brendan Haigis, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1 Genesys Pkwy, Grand Blanc, MI 48439 Phone: 810-606-6372
Roland R Tindle, D.O. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 8401 Holly Rd, Grand Blanc, MI 48439 Phone: 810-695-8011 Fax: 810-695-8002
Dr. Ryan Patrick Kirby, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1 Genesys Pkwy, Grand Blanc, MI 48439 Phone: 810-606-5000

Dr Jack Douglas Dehaan, MD - Medicare Emergency Medicine in Grand Blanc, MI