NPIMap

Individual provider Active NPI

Jeffrey Joseph Vanwingen, M.D.

  • Family Medicine Physician
  • Grand Rapids, MI
National Provider Identifier
1053349993
Registry record updated Apr 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
JV070262 Issued in MI
Practice address
721 3 Mile Rd NW
Suite 200
Grand Rapids, MI 49544-8229
Phone
(616) 647-3770
Fax
(616) 647-3776
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X JV070262 MI Primary

Addresses

Primary practice location

721 3 Mile Rd NW
Suite 200
Grand Rapids, MI 49544-8229

Mailing address

721 3 Mile Rd NW
Suite 200
Grand Rapids, MI 49544-8229
Phone (616) 647-3770

Other identifiers 5

IdentifierTypeStateIssuer
0804109762OtherBC/BS
4194806MedicaidMI
7976213OtherMIAETNA
PH14829OtherMIPRIORITY HEALTH
P106669OtherMIBLUE CARE NETWORK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050728000566 MI Practitioner - Family Practice 1153359450 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Human Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
A Plus Medical Associates PLLCGroup PAC ID 0941610596, 8 clinicians

Practice addresses (Care Compare)

2849 Michigan St NE
Suite 102
Grand Rapids, MI 49506-1216
Phone (616) 285-6450

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
JV070262MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
A Plus Medical Associates PLLC Family Medicine CurrentSince Jan 1, 2024 Accepting new patients
Advantage Health Saint Mary's Medical Group CurrentSince Aug 1, 2013 Accepting new patients
Advantage Health/Saint Mary's Medical Group CurrentSince Aug 1, 2013 Accepting new patients
A F Associates Family Medicine PC Family Medicine Current Accepting new patients
Advantage Health/Saint Mary's Medical Group Current Accepting new patients
Odyssey Healthcare Holding Company Family Medicine PastSince Oct 1, 2021 Accepting new patients

Locations

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

245 State St SE
Ste 1A
Grand Rapids, MI 49503

220 Cherry St SE
Grand Rapids, MI 49503
Phone (616) 685-5576

2849 Michigan St NE
Ste 102
Grand Rapids, MI 49506
Phone (616) 285-6450

200 Jefferson Ave SE
Grand Rapids, MI 49503
Phone (616) 685-5000

Interoperability endpoints

  • Direct secure messaging: jeffrey.vanwingen.1@19662.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/19662/brand/1/csg/1/fhir/r4

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Heartland Hospice (Flint)Flint, MI, CCN 231589 Hospice Contracted Managing Employee Oct 1, 2021
Heartland Hospice (Mason)Okemos, MI, CCN 231588 Hospice Contracted Managing Employee Aug 1, 2024
Heartland Hospice (Grand Rapids)Grand Rapids, MI, CCN 231582 Hospice Contracted Managing Employee Oct 1, 2021

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271289600000",
    "number": "1053349993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 3 MILE RD NW",
            "address_2": "SUITE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495448229",
            "telephone_number": "616-647-3770",
            "fax_number": "616-647-3776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 3 MILE RD NW",
            "address_2": "SUITE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495448229",
            "telephone_number": "616-647-3770",
            "fax_number": "616-647-3776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANWINGEN",
        "first_name": "JEFFREY",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2010-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "JV070262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "0804109762",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4194806",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7976213",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIORITY HEALTH",
            "identifier": "PH14829",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "P106669",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.