Phillip Isaac Van, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

V7093 Issued in TX

Practice address

4900 Mueller Blvd
Austin, TX 78723-3051

Phone

(512) 324-9999

Fax

(512) 517-9064

NPI assigned

Apr 6, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Psychiatry

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: phillip.van.1@8363.direct.athenahealth.com

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.

• Newaygo County Mental Health Board

  • Community/Behavioral Health Agency
  • White Cloud, MI
  • NPI 1376512236

  MI, Psychiatry

  Medicare reassignment NPD
• Newaygo County Mental Health Board

  • Psychiatry Physician
  • White Cloud, MI
  • NPI 1386969996

  Psychiatry

  NPD

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

{
    "created_epoch": "1649203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1194466680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 MUELLER BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233051",
            "telephone_number": "512-324-9999",
            "fax_number": "512-517-9064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 MUELLER BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233051",
            "telephone_number": "512-324-9999",
            "fax_number": "512-517-9064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN",
        "first_name": "PHILLIP",
        "middle_name": "ISAAC",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-06",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4351050224",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "V7093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Van Tassel, LCSW
• Kathleen Van Tiem
• Van Van Nguyen MD PA
• Steven Lester Van Wicklen, D.D.S.
• Shannon Van Zandt
• Vanaja Associates, M.D., P.a
• Suzanne Lisette Vanbenthuysen, MD
• Andrea Kathryn Vance, MSN, APRN, NNP-BC
• James L Vance, DC
• Olivia Maggitti Vance, CRNA

• All providers in Austin, TX
• Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.