Brandon Willem Vanderwel, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD60786062 Issued in WA

Practice address

19930 Ballinger Way NE
Shoreline, WA 98155-1223

Phone

(425) 778-2220

NPI assigned

Jun 4, 2013

Last updated

Aug 20, 2019By 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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Dec 12, 2019 through Dec 12, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Puget Sound Surgical Center

  • Ambulatory Surgical Clinic/Center
  • Shoreline, WA
  • NPI 1922477645
  NPD (past)
• Puget Sound Surgical Clinic Inc

  • Surgery Physician
  • Shoreline, WA
  • NPI 1699785527
  NPD (past)

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

{
    "created_epoch": "1370304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1144667858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1965 COULSTON ST APT 14",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923541741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19930 BALLINGER WAY NE",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981551223",
            "telephone_number": "425-778-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERWEL",
        "first_name": "BRANDON",
        "middle_name": "WILLEM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-04",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD60786062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "MD60786062",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anusha Vadlamudi, M.D.
• Hannah Christine Valentine, M.S., CF-SLP
• Tory Rose Valentine, MSW, LSWAIC
• Lana Van Boven
• Stephanie Ann Van Cleave, RN
• Jennifer Bonaro Vanderwerff, SLP
• Lisa J Vanhorne, MSCCC-SLP
• Maria Luisa Vargas
• Maria Consuelo Vaughn, RPH
• Georgia Vazquez

• Surgery Physician in Shoreline, WA
• Providers in Shoreline, WA by specialty
• Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.