Individual provider Active NPI

Katy Van Donselaar, D.O.

  • Emergency Medicine Physician
  • Saginaw, MI
National Provider Identifier
1144671983
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5101022741 Issued in MI
Practice address
1000 Houghton Ave
Saginaw, MI 48602-5303
Phone
(989) 583-6800
NPI assigned
Jun 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 20A18350 CA
Emergency Medicine Physician 207P00000X 5101022741 MI Primary

Addresses

Primary practice location

1000 Houghton Ave
Saginaw, MI 48602-5303

Mailing address

1000 Houghton Ave
Saginaw, MI 48602-5303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20200722003479 CA Practitioner - Emergency Medicine 7113219387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - CaliforniaGroup PAC ID 6103739131, 1,278 clinicians

Practice addresses (Care Compare)

1700 Coffee Rd
Modesto, CA 95355-2803
Phone (209) 526-4500

Hospital & facility affiliations

  • Memorial Medical Center Hospital, Modesto, CA, CCN 050557

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18350CAMDAcupuncturist
20A18350CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine CurrentSince Jul 21, 2020 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Jul 21, 2020 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients

Locations

1650 Creekside Dr
Folsom, CA 95630
Phone (916) 983-7400

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1441 Florida Ave
Modesto, CA 95350
Phone (209) 214-7235

1700 Coffee Rd
Modesto, CA 95355
Phone (209) 526-4500

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

Interoperability endpoints

  • Direct secure messaging: kvandonselaar552800@hisp.ehr.sutterhealth.org

Organizations & group practices 3

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 1

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": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1144671983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HOUGHTON AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486025303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HOUGHTON AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486025303",
            "telephone_number": "989-583-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DONSELAAR",
        "first_name": "KATY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-23",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A18350",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101022741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

Verify at the official NPI Registry.