Individual provider Active NPI

Anne Kirsten Vanden Belt, M.D.

  • Pediatrics Physician
  • Ypsilanti, MI
National Provider Identifier
1154381648
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301067351 Issued in MI
Practice address
5301 E Huron River Dr
St. Joseph Mercy Hospital Department of Pediatrics
Ypsilanti, MI 48197-1051
Phone
(734) 712-5880
Fax
(734) 712-5525
NPI assigned
Mar 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301067351 MI Primary

Addresses

Primary practice location

5301 E Huron River Dr
St. Joseph Mercy Hospital Department of Pediatrics
Ypsilanti, MI 48197-1051

Mailing address

3423 W Delhi Rd
Ann Arbor, MI 48103-9411
Phone (734) 649-4973

Other practice location 1

5841 S Maryland Ave
Chicago, IL 60637-1443
Phone (773) 702-9797

Other identifiers 2

IdentifierTypeStateIssuer
700H161150OtherMIBLUE SHIELD PROVIDER NO.
7219AOtherMICAPE PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20230724001018 IL Practitioner - Pediatric Medicine 3971678640 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301067351MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Chicago CurrentSince May 29, 2023 Accepting new patients
The University of Chicago Medical Center CurrentSince May 29, 2023 Accepting new patients
The University of Chicago Medical Center CurrentSince May 29, 2023 Accepting new patients
St Joseph Mercy Hospital Past Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

6501 S Promontory Dr
Chicago, IL 60649
Phone (773) 256-5724

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

Interoperability endpoints

  • Direct secure messaging: anne.vanden.belt.1@11074.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1154381648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3423 W DELHI RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481039411",
            "telephone_number": "734-649-4973",
            "fax_number": "734-712-5525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 E HURON RIVER DR",
            "address_2": "ST. JOSEPH MERCY HOSPITAL DEPARTMENT OF PEDIATRICS",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971051",
            "telephone_number": "734-712-5880",
            "fax_number": "734-712-5525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5841 S Maryland Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606371443",
            "country_code": "US",
            "telephone_number": "773-702-9797",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDEN BELT",
        "first_name": "ANNE",
        "middle_name": "KIRSTEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-27",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301067351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROVIDER NO.",
            "identifier": "700H161150",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPE PIN",
            "identifier": "7219A",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.