DANIEL MARK MANKOFF (NPI# 1306803010) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306803010 |
| Entity Type | Individual |
| Full Name | DANIEL MARK MANKOFF |
| Credential | MD |
| Practice Address |
4100 Lake Dr Se Suite 305 Grand Rapids MI 49546 |
| Mailing Address |
61 Commerce Ave Sw Grand Rapids MI 49503-4124 |
| Practice Telephone | 6162851377 |
| Practice Fax Number | 6162851006 |
| Mailing Telephone | 6169400660 |
| Mailing Fax Number | 6169401965 |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2008-11-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
4301044741 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4552942-10 | 05 | |
| MI | 5205950-10 | 05 | |
| MI | 4532260-10 | 05 | |
| MI | BCBSM | 550410219 | 01 |
| MI | 4592429-10 | 05 |
| Street Address |
4100 LAKE DR SE SUITE 305 |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49546 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366438632 | Spectrum Health Hospitals | Clinic/Center | 4100 Lake Dr Se, Grand Rapids, MI 49546-8292 | 2005-09-22 |
| 1073146411 | James Walejewski | Specialist/Technologist | 4100 Lake Dr Se, Grand Rapids, MI 49546-8292 | 2020-02-13 |
| 1811458557 | Michelle Kuzma | Specialist/Technologist | 4100 Lake Dr Se, Grand Rapids, MI 49546-8292 | 2019-03-26 |
| 1063943991 | Maggie Anstett | Specialist/Technologist | 4100 Lake Dr Se, Suite 300, Grand Rapids, MI 49546-8292 | 2017-03-22 |
| 1851746671 | Luke Murray | Specialist/Technologist | 4100 Lake Dr Se, Suite 300, Grand Rapids, MI 49546-8292 | 2016-04-29 |
| 1942665237 | Alyssa Susanne Baker | Specialist/Technologist | 4100 Lake Dr Se, Suite 300, Grand Rapids, MI 49546-8292 | 2015-12-31 |
| 1619332806 | Elizabeth Albert | Specialist/Technologist | 4100 Lake Dr Se, Suite 300, Grand Rapids, MI 49546-8292 | 2015-12-15 |
| 1609247618 | Rebecca Preston | Psychologist | 4100 Lake Dr Se, Suite B01, Grand Rapids, MI 49546-8292 | 2015-10-16 |
| 1255708921 | Timothy Glerum | Nurse Practitioner | 4100 Lake Dr Se, Suite 205, Grand Rapids, MI 49546-8292 | 2015-08-28 |
| 1730556796 | Samantha Ford | Specialist/Technologist | 4100 Lake Dr Se, Grand Rapids, MI 49546-8292 | 2015-08-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437762986 | Amanda Mae Ostrom | Speech-Language Pathologist | 710 Kenmore Ave Se, #110, Grand Rapids, MI 49546 | 2020-08-25 |
| 1063075562 | Kelly Lynn Ibarra | Counselor | 4467 Cascade Road Se, Suite #4479, Grand Rapids, MI 49546 | 2019-04-19 |
| 1891257036 | Jessica Matthews LLC | Counselor | 4127 Embassy Drive Se, Grand Rapids, MI 49546 | 2019-04-05 |
| 1326518531 | Neah Morgan | Technician | 4220 Burton St Se, Grand Rapids, MI 49546 | 2018-11-29 |
| 1316430267 | Michael John Benskey | Case Manager/Care Coordinator | 4065 Saladin St Se, Grand Rapids, MI 49546 | 2018-06-14 |
| 1679062772 | Smile Cascade, P.C. | Clinic/Center | 4505 Cascade Rd Se # A, Grand Rapids, MI 49546 | 2018-05-03 |
| 1720583289 | Jeromy Krogman | Counselor | 826 Parchment Drive Se, Grand Rapids, MI 49546 | 2018-03-27 |
| 1841792660 | Affordable Hearing Clinic | Hearing Instrument Specialist | 833 Kenmoor Ave Se Ste G, Grand Rapids, MI 49546 | 2018-03-07 |
| 1689176133 | Kelly Pines | Physical Therapist | 625 Kenmoor Ave Suite 306, Grand Rapids, MI 49546 | 2018-03-01 |
| 1467971440 | Deanna Elizabeth Saenz | Social Worker | 2100 Raybrook St Se Ste 300, Grand Rapids, MI 49546 | 2017-09-12 |
| Find all providers in zip 49546 | ||||
| Taxonomy Code | 208VP0014X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Interventional Pain Medicine |
| Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164664082 | Javery Pain Institute PC | Pain Medicine | 710 Kenmoor Ave Se, Suite 200, Grand Rapids, MI 49546-2379 | 2009-03-25 |
| 1134186513 | Bennett L Willard | Pain Medicine | 4100 Lake Dr Se, Suite 305, Grand Rapids, MI 49546 | 2006-04-28 |
| 1376509158 | Stephen Lee Winston | Pain Medicine | 4100 Lake Dr Se, Suite 305, Grand Rapids, MI 49546 | 2006-04-21 |
| 1457315095 | Joseph Yared Vanden Bosch | Pain Medicine | 4100 Lake Dr Se, Suite 305, Grand Rapids, MI 49546 | 2006-04-12 |
| 1619930575 | Thomas Michael Basch | Pain Medicine | 4100 Lake Dr Se, Ste 305, Grand Rapids, MI 49546 | 2006-04-10 |
| 1619938545 | Mark Louis Gostine | Pain Medicine | 2060 E Paris Ave Se, Suite 200, Grand Rapids, MI 49546-6113 | 2006-03-30 |
| 1144281080 | Kevin Edward Fitzgerald | Pain Medicine | 4100 Lake Dr Se, Ste 305, Grand Rapids, MI 49546 | 2006-03-30 |
| 1225099161 | Fred Neal Davis | Pain Medicine | 2060 E Paris Ave Se, Suite 200, Grand Rapids, MI 49546-6113 | 2006-03-30 |
| 1225007206 | Scott Howard Greenwald | Pain Medicine | 4100 Lake Dr Se, Suite 305, Grand Rapids, MI 49546 | 2006-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558903294 | Comprehensive Pain Specialists, Pllc | Pain Medicine | 4302 Bay City Rd, Midland, MI 48642-6014 | 2019-10-15 |
| 1437715232 | Comprehensive Pain Specialists, Pllc | Pain Medicine | 705 E Frank St, Caro, MI 48723 | 2019-05-16 |
| 1083175913 | Bella Treatment Center PC | Pain Medicine | 28763 Northwestern Hwy Ste 100, Southfield, MI 48034-1842 | 2019-03-25 |
| 1245795848 | Advanced Pain Management Specialists, LLC | Pain Medicine | 46325 W 12 Mile Rd Ste 335, Novi, MI 48377-2464 | 2019-02-07 |
| 1356738686 | Genesee Pain Associates PC | Pain Medicine | 4468 Oakbridge Dr, Flint, MI 48532-5422 | 2015-04-24 |
| 1457745150 | Strategy Anesthesia Michigan Pllc | Pain Medicine | 13460 Fort St, Southgate, MI 48195-1138 | 2015-03-20 |
| 1407115884 | Michiana Spine, Sports & Occupational Rehab, PC | Pain Medicine | 2500 Niles Rd Ste 3, Saint Joseph, MI 49085-3225 | 2012-05-07 |
| 1386902013 | Michiana Spine, Sports & Occupational Rehab, PC | Pain Medicine | 24 N Saint Joseph Ave Ste B, Niles, MI 49120-2263 | 2012-05-01 |
| 1225302821 | Pain Clinic Management Group, Pllc | Pain Medicine | 35634 Dequindre Rd, Sterling Heights, MI 48310-4288 | 2012-02-28 |
| 1740567163 | Northville Pain Specialists Plc | Pain Medicine | 215 E. Main Street, Suite 201, Northville, MI 48167-1686 | 2011-11-14 |
| Find all providers with the same taxonomy | ||||
| City | GRAND RAPIDS |
| Zip Code | 49546 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.