Teresa Ellen Kovas, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4301099708 Issued in MI

Practice address

907 E Tinkham Ave
Ludington, MI 49431-1537

Phone

(231) 843-3477

Fax

(231) 843-9042

NPI assigned

Apr 16, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Teresa Ellen Vandenbergh Former name

Electronic endpoints 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

Specialty

Pediatric Medicine

Education

Wayne State University School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Memorial Medical Center of West MichiganGroup PAC ID 3678543659, 62 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tkovas117147@epic00.corewelldirect.org

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

• Memorial Medical Center of West Michigan

  • General Acute Care Hospital
  • Ludington, MI
  • NPI 1972589489
  Medicare reassignment Care Compare group NPD
• Edward W. Sparrow Hospital Association

  • Pediatrics Physician
  • Lansing, MI
  • NPI 1831139088
  Medicare reassignment NPD
• Edward W Sparrow Hospital Association

  • Adult Health Nurse Practitioner
  • Lansing, MI
  • NPI 1265220438
  NPD

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1043435779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-486-6790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 E TINKHAM AVE",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494311537",
            "telephone_number": "231-843-3477",
            "fax_number": "231-843-9042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVAS",
        "first_name": "TERESA",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "WI",
            "license": "52893",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301099708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tkovas117147@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "907 E Tinkham Ave",
            "city": "Ludington",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494311537",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "907 E Tinkham Ave",
            "city": "Ludington",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494311537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "VANDENBERGH",
            "middle_name": "ELLEN",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• William Maurice Kokx, DO
• Starr Koon
• Tyler Koops
• Ann Koss, DO
• Bryan Anthony Kovas, M.D.
• Sceone Maren Kraai, PA-C
• Leah Erin Kruk, DNP FNP
• Carol Ann Kubanek-Erdman, R.N.
• Sarah Kucera
• Nathaniel Thomas Ladaga, DO

• Pediatrics Physician in Ludington, MI
• Providers in Ludington, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.