DR. DAVID MICHAEL LISCOW (M.D.) – Family Medicine Physician, NPI 1689786154

DR. DAVID MICHAEL LISCOW (M.D.) is a healthcare provider. based in South haven, Michigan. specializing in Family Medicine Physician. They hold the professional credentials M.D.. They hold a License No. 4301048560 (MI). The NPI Number for DR. DAVID MICHAEL LISCOW (M.D.) is 1689786154

Main info

Male
44 Years Of Experience
Accepts Medicare Assignment
Name
DR. DAVID MICHAEL LISCOW (M.D.)
NPI
1689786154
Phone
(269) 637-1115
Address
930 BLUE STAR HWY
Enumeration Date
31 August 2006
Last Update Date
1 December 2020

Doctor Profile

Medical School Name
UNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE
Secondary Phone
2696392796
Graduation Year
1982 (44 years ago)
PAC ID
2264598796
Group Practice PAC ID
6204724834
Professional Enrollment ID
I20100130000372

Contacts

Secure Messaging
direct@direct.bronsonhg.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

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Provider Addresses for DR. DAVID MICHAEL LISCOW (M.D.)

  • Blue Star Highway, South Haven, South Haven Charter Township, Van Buren County, Michigan, 49090, United States

    SOUTH HAVEN, MI 490907758

    Phone: (269) 637-1115

    Fax: (269) 639-1314

    Mailing address matches the actual address.

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: 2010-01-30

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
I20100130000372IFamily 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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49090)

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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: 6204724834View full group profile
NameSpecialtyState
Family PracticePA
Physician AssistantMI
O B S T E T R I C S/ G Y N E C O L O G YMI
Certified Nurse Midwife (Cnm)MI
O B S T E T R I C S/ G Y N E C O L O G YMI
Family Practice, Hospice/Palliative CareMI
Cardiovascular Disease (Cardiology)MI
Certified Nurse Midwife (Cnm)MI
Physician AssistantMI
Family PracticeMI

Reviews

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Frequently asked questions

What identifier follows DR. DAVID MICHAEL LISCOW (M.D.) across health systems?
The NPI 1689786154 uniquely identifies DR. DAVID MICHAEL LISCOW (M.D.) in U.S. healthcare data.
Is DR. DAVID MICHAEL LISCOW (M.D.)'s NPI status active today?
Active status means DR. DAVID MICHAEL LISCOW (M.D.)'s NPI record is not deactivated in the public file.
How should patients interpret DR. DAVID MICHAEL LISCOW (M.D.)'s specialty?
The extract shows Family Medicine Physician for DR. DAVID MICHAEL LISCOW (M.D.). Clinical services aligned with this taxonomy classification.
Is DR. DAVID MICHAEL LISCOW (M.D.) tied to South Haven, Michigan?
If you are local to South Haven, Michigan, DR. DAVID MICHAEL LISCOW (M.D.) may be relevant to your search.
Can I export DR. DAVID MICHAEL LISCOW (M.D.)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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