Individual provider Active NPI

Zachary Thomas Vandeveer, MD

  • Vascular & Interventional Radiology Physician
  • Grand Rapids, MI
National Provider Identifier
1144915232
Registry record updated May 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
4351051218 Issued in MI
Practice address
100 Michigan St NE Ste A601
Grand Rapids, MI 49503-2560
Phone
(616) 391-6243
NPI assigned
Apr 6, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 4351051218 MI Primary

Addresses

Primary practice location

100 Michigan St NE Ste A601
Grand Rapids, MI 49503-2560

Mailing address

100 Michigan St NE Ste A601
Grand Rapids, MI 49503-2560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20230623001172 MI Order and Referring Only - General SurgeryPractitioner - General Surgery 3476911470

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4351051218MIMDVascular & Interventional Radiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1680739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779667200000",
    "number": "1144915232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE STE A601",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE STE A601",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-391-6243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDEVEER",
        "first_name": "ZACHARY",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-06",
        "last_updated": "2026-05-25",
        "certification_date": "2026-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MI",
            "license": "4351051218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.