Individual provider Active NPI

Alexander Vandenende, DO

  • Psychiatry Physician
  • Saginaw, MI
National Provider Identifier
1194347716
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
5101026645 Issued in MI
Practice address
4200 Fashion Square Blvd Ste 201
Saginaw, MI 48603-1375
Phone
(833) 351-8255
NPI assigned
May 18, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 331186 NY
Psychiatry Physician 2084P0800X 34.017387 OH
Psychiatry Physician 2084P0800X 5101026645 MI Primary

Addresses

Primary practice location

4200 Fashion Square Blvd Ste 201
Saginaw, MI 48603-1375

Mailing address

PO Box 24449
New York, NY 10087-0589
Phone (833) 351-8255

Other practice location 1

109 W 27th St Ste 5S
New York, NY 10001-0265
Phone (833) 351-8255

Other practice location 2

1 W Winter St Ste 200
Delaware, OH 43015-4635
Phone (833) 351-8255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, OH, MI3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20240725004120 NY Practitioner - Psychiatry 3678019643 Reassigns benefits to 1 organization
I20240803000393 OH Practitioner - Psychiatry 3678019643 Reassigns benefits to 1 organization
I20240813002090 MI Practitioner - Psychiatry 3678019643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MCCD FL Psychiatry Services PAGroup PAC ID 4880064070, 751 clinicians

Practice addresses (Care Compare)

455 E Eisenhower Pkwy
Suite 300
Ann Arbor, MI 48108-3324
Phone (833) 351-8255

9435 Waterstone Blvd
Suite 140
Cincinnati, OH 45249-8229
Phone (833) 351-8255

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101026645MIMDPsychiatry Physician
331186NYMDPsychiatry Physician
34.017387OHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCCD Psychiatry Services PLLC Psychiatry CurrentSince Jul 22, 2024 Accepting new patients
MCCD FL Psychiatry Services PA Psychiatry CurrentSince Jul 22, 2024 Accepting new patients

Locations

455 E Eisenhower Pkwy
Ste 300
Ann Arbor, MI 48108
Phone (517) 580-5727

4200 Fashion Square Blvd
Ste 201
Saginaw, MI 48603
Phone (872) 368-4123

109 W 27th St
#55
New York, NY 10001

109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572

9435 Waterstone Blvd
Ste 140
Cincinnati, OH 45249
Phone (513) 613-2977

1 W Winter St
Ste 200
Delaware, OH 43015
Phone (513) 828-0285

Interoperability endpoints

  • Direct secure messaging: alexander.vandenende.1@19827.direct.athenahealth.com

Organizations & group practices 2

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": "1589760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1194347716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24449",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100870589",
            "telephone_number": "833-351-8255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 FASHION SQUARE BLVD STE 201",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486031375",
            "telephone_number": "833-351-8255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 W 27th St Ste 5S",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100010265",
            "country_code": "US",
            "telephone_number": "833-351-8255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 W Winter St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Delaware",
            "state": "OH",
            "postal_code": "430154635",
            "country_code": "US",
            "telephone_number": "833-351-8255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDENENDE",
        "first_name": "ALEXANDER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-18",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "331186",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "34.017387",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "5101026645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

Verify at the official NPI Registry.