IRIS BOURBON DANIEL (MD) – Family Medicine Physician, NPI 1205840691

IRIS BOURBON DANIEL (MD) is a healthcare provider. based in Macomb, Michigan. specializing in FAMILY PRACTICE, UNDERSEA AND HYPERBARIC MEDICINE. They hold the professional credentials MD. They hold a License No. 4301061948 (MI). The NPI Number for IRIS BOURBON DANIEL (MD) is 1205840691

Main info

Female
37 Years Of Experience
Accepts Medicare Assignment
Name
IRIS BOURBON DANIEL (MD)
NPI
1205840691
Phone
(586) 868-9800
Address
46591 ROMEO PLANK RD STE 205
Enumeration Date
28 July 2006
Last Update Date
16 May 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1989 (37 years ago)
PAC ID
1951389121
Group Practice PAC ID
7517162761
Professional Enrollment ID
I20040713000853
Address ID
MI480445705MA46591RDXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

4,418 FAMILY PRACTICE in MI

Provider Addresses for IRIS BOURBON DANIEL (MD)

  • 46591 ROMEO PLANK RD STE 205

    MACOMB, MI 480445705

    Phone: (586) 868-9800

    Fax: (586) 868-9801

    Type: Location

  • 42490, Garfield Road, Clinton Township, Macomb County, Michigan, 48038, United States

    SUITE 207

    CLINTON TWP, MI 48038

    Phone: (586) 263-7900

    Fax: (586) 263-0434

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-07-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040713000853IFamily PracticeMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes2812$0
View full utilization report →

Insurance plans in this area (ZIP 48044)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7517162761View full group profile
NameSpecialtyState
Family PracticeMI
Internal MedicineMI
Family PracticeMI
Hospitalist, Internal Medicine, Hospitalist, Internal MedicineMI
-MI
Internal MedicineMI
-MI
Family PracticeMI
-MI
Family PracticeMI

Reviews

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Frequently asked questions

What is the standard ID for IRIS BOURBON DANIEL (MD) in the U.S.?
In the U.S., IRIS BOURBON DANIEL (MD) is identified by NPI 1205840691.
Does the public listing show IRIS BOURBON DANIEL (MD) as active?
IRIS BOURBON DANIEL (MD)'s NPI record reflects an active status in NPPES.
What type of care does IRIS BOURBON DANIEL (MD) provide?
IRIS BOURBON DANIEL (MD)'s profile centers on Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Is IRIS BOURBON DANIEL (MD) tied to Macomb, Michigan?
If you are local to Macomb, Michigan, IRIS BOURBON DANIEL (MD) may be relevant to your search.
Why is information missing for IRIS BOURBON DANIEL (MD)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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