Jeffrey Theodore Vangelderen, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4301405970 Issued in MI

Practice address

248 Washington Ave
Suite a
Bay City, MI 48708-5848

Phone

(989) 892-5664

Fax

(989) 892-0662

NPI assigned

Jul 7, 2005

Last updated

Dec 19, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/7895/brand/1/csg/1/fhir/r4
• Direct secure messaging: jeffrey.vangelderen.p1@direct.cmgsagbay.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Childrens Medical Group of Saginaw Bay PLLC

  • Pediatrics Physician
  • Bay City, MI
  • NPI 1902972748
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1043217979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "248 WASHINGTON AVE",
            "address_2": "SUITE A",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487085848",
            "telephone_number": "989-892-5664",
            "fax_number": "989-892-0662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248 WASHINGTON AVE",
            "address_2": "SUITE A",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487085848",
            "telephone_number": "989-892-5664",
            "fax_number": "989-892-0662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANGELDEREN",
        "first_name": "JEFFREY",
        "middle_name": "THEODORE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301405970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3418136",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3419062",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica Renee Vanderhaar
• Elizabeth Vanderhart
• Douglas Gene Vanderlaan, MA, LPC
• Jeannette Marie Vandusen
• Megan Joy Vanever, L.L.M.S.W.
• Breian Vanhaaren
• Carissa Vanhoey
• Paul Vanhoof
• Sharon Vanmullekom, PT
• Emma Vannest

• Pediatrics Physician in Bay City, MI
• Providers in Bay City, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.