NPIMap

Individual provider Active NPI

David G Vandebunte, PA-C

  • Physician Assistant
  • Charlotte, MI
National Provider Identifier
1053955633
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601009742 Issued in MI
Practice address
616 Meijer St
Charlotte, MI 48813-8457
Phone
(517) 541-5935
NPI assigned
Nov 6, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601009742 MI Primary

Addresses

Primary practice location

616 Meijer St
Charlotte, MI 48813-8457

Mailing address

1206 Runaway Bay Dr Apt 3B
Lansing, MI 48917-8743
Phone (616) 717-2503

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
I20200221000126 MI Practitioner - Physician Assistant 4486081031 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Edward W Sparrow Hospital AssociationGroup PAC ID 6709799166, 698 clinicians

Practice addresses (Care Compare)

616 Meijer Dr
Charlotte, MI 48813-8457
Phone (517) 541-5935

800 E Columbia St
Mason, MI 48854-1381

Hospital & facility affiliations

  • Edward W Sparrow Hospital Hospital, Lansing, MI, CCN 230230
  • University of Michigan Health - Sparrow Eaton Hospital, Charlotte, MI, CCN 231327

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601009742MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sparrow Carson Hospital CurrentSince Dec 1, 2024 Accepting new patients
Sparrow Carson Hospital CurrentSince Dec 1, 2024 Accepting new patients
Sparrow Ionia Hospital CurrentSince Dec 1, 2024 Accepting new patients
Sparrow Eaton Hospital CurrentSince Jan 7, 2020 Accepting new patients
Sparrow Eaton Hospital CurrentSince Jan 7, 2020 Accepting new patients
Edward W. Sparrow Hospital Association CurrentSince Jan 5, 2022 Accepting new patients
Edward W. Sparrow Hospital Association Past Accepting new patients
Sparrow Carson Hospital Past Accepting new patients
Sparrow Ionia Hospital Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

102 S 3rd St
Ste 100
Carson City, MI 48811
Phone (989) 584-1308

111 Lansing St
Ste 110
Charlotte, MI 48813
Phone (517) 541-5855

123 Lansing St
Ste 2
Charlotte, MI 48813
Phone (517) 541-5954

616 Meijer Dr
Charlotte, MI 48813
Phone (517) 541-5935

1014 E Washington St
Greenville, MI 48838
Phone (616) 754-7145

550 E Washington St
Ionia, MI 48846
Phone (616) 523-1600

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

1004 E Michigan Ave
Lansing, MI 48912
Phone (517) 364-9790

716 N Clippert St
Lansing, MI 48912
Phone (517) 253-4000

800 E Columbia St
Mason, MI 48854
Phone (517) 244-8900

Organizations & group practices 12

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 5

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": "1572998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1053955633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 RUNAWAY BAY DR APT 3B",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489178743",
            "telephone_number": "616-717-2503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 MEIJER ST",
            "city": "CHARLOTTE",
            "state": "MI",
            "postal_code": "488138457",
            "telephone_number": "517-541-5935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDEBUNTE",
        "first_name": "DAVID",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-06",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601009742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, MI

Sources for this page

Verify at the official NPI Registry.