Roelof A. Van Der Meulen, DPT, ECS

Primary specialty

Clinical Electrophysiology Physical TherapistTaxonomy code 2251E1300X

License

4175 Issued in TN

Practice address

4701 Simona Rd
Knoxville, TN 37918-4535

Phone

(865) 776-3757

NPI assigned

Apr 18, 2007

Last updated

Dec 27, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Summit Medical Group, PLLCGroup PAC ID 2860396330, 636 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Summit Medical Group, PLLC

  dba Cool Springs Internal Medicine and Pediatrics

  • Internal Medicine Physician
  • Brentwood, TN
  • NPI 1659090298
  Medicare reassignment Care Compare group NPD
• Neurosolutions, LLC

  • Clinical Electrophysiology Physical Therapist
  • Knoxville, TN
  • NPI 1124364245

  Electrophysiology, Clinical

  NPD (past) Authorized official
• Summit Medical Group, PLLC

  dba Rheumatology Assoc. of East TN

  • Rheumatology Physician
  • Knoxville, TN
  • NPI 1053480004
  NPD
• Summit Medical Group, PLLC

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1699722470
  NPD (past)

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356566400000",
    "number": "1083830996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 SIMONA RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379184535",
            "telephone_number": "865-776-3757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 SIMONA RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379184535",
            "telephone_number": "865-776-3757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DER MEULEN",
        "first_name": "ROELOF",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "DPT, ECS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2012-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251E1300X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Electrophysiology, Clinical",
            "state": "TN",
            "license": "4175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "4175",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3654099",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LEGACY GROUP",
            "identifier": "3717547",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meredith Ann Valk, M.S. CCC-SLP
• Allison Valles
• Justin Christopher Valois
• Lakshmi Rekha Van Camp
• Floor Annemarie Van Der Meulen, PT
• Jessica Lee Van Haaften
• Stuart E Van Meter, MD
• Jaclyn Beth Van Nes, M.D.
• Catherine Ann Van Ostrand, RN, MSN, CDE, PCNS-B
• Vanessa Van Slambrook

• Physical Therapist in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.