Katrina T Vanderveen, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

01058810 Issued in IN

Practice address

620 W Edison Rd
Suite 110
Mishawaka, IN 46545-2784

Phone

(574) 258-1100

Fax

(574) 258-1101

NPI assigned

Sep 13, 2005

Last updated

May 16, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 8

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI, IN2 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 2

Specialty

Diagnostic Radiology

Education

University of Virginia School of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Radiology IncGroup PAC ID 5890695464, 35 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital of South Bend Hospital, South Bend, IN, CCN 150058
• Elkhart General Hospital Hospital, Elkhart, IN, CCN 150018
• Goshen Hospital Hospital, Goshen, IN, CCN 150026
• Three Rivers Health Hospital, Three Rivers, MI, CCN 230015
• Franciscan Health Michigan City Hospital, Michigan City, IN, CCN 150015

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kvanderveen523944@direct.franciscanalliance.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Radiology, Inc

  • Diagnostic Radiology Physician
  • Mishawaka, IN
  • NPI 1578557815

  MI

  Medicare reassignment Care Compare group
• Beacon Health, LLC

  dba Beacon Imaging Mishawaka

  • Diagnostic Radiology Physician
  • Mishawaka, IN
  • NPI 1912796699
  NPD
• Beacon Health, LLC

  dba Beacon Imaging

  • Diagnostic Radiology Physician
  • Goshen, IN
  • NPI 1952982217
  NPD
• Memorial Lighthouse Imaging LLC

  • Diagnostic Ultrasound Physician
  • South Bend, IN
  • NPI 1730225848

  Body Imaging

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Elkhart General Hospital, Inc.

  • General Acute Care Hospital
  • Elkhart, IN
  • NPI 1477551489
  Care Compare affiliation
• Franciscan Health Michigan City

  dba Franciscan Health Michigan City at La Porte

  • General Acute Care Hospital
  • La Porte, IN
  • NPI 1679336747
  Care Compare affiliation
• Franciscan Health Michigan City

  • General Acute Care Hospital
  • Michigan City, IN
  • NPI 1710051941
  Care Compare affiliation
• Goshen Hospital Association Inc

  • General Acute Care Hospital
  • Goshen, IN
  • NPI 1740268846
  Care Compare affiliation
• Memorial Hospital of South Bend

  • General Acute Care Hospital
  • South Bend, IN
  • NPI 1295772093
  Care Compare affiliation
• Memorial Hospital of South Bend

  dba Memorial Epworth Center

  • Psychiatric Hospital Unit
  • South Bend, IN
  • NPI 1376841395
  Care Compare affiliation
• Memorial Hospital of South Bend

  dba Beacon Granger Hospital, A Memorial Hospital Extension

  • General Acute Care Hospital
  • Granger, IN
  • NPI 1881177756
  Care Compare affiliation
• Three Rivers Health System, Inc

  dba Three Rivers Health

  • General Acute Care Hospital
  • Three Rivers, MI
  • NPI 1568739423
  Care Compare affiliation

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368662400000",
    "number": "1194710541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 W EDISON RD",
            "address_2": "SUITE 110",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465452784",
            "telephone_number": "574-258-1100",
            "fax_number": "574-258-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 W EDISON RD",
            "address_2": "SUITE 110",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465452784",
            "telephone_number": "574-258-1100",
            "fax_number": "574-258-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERVEEN",
        "first_name": "KATRINA",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-13",
        "last_updated": "2013-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "IN",
            "license": "01058810",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "IN",
            "license": "01058810",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "IN",
            "license": "01058810",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "IN",
            "license": "01058810",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01058810",
            "primary": true
        },
        {
            "code": "2085R0203X",
            "taxonomy_group": "",
            "desc": "Radiology, Therapeutic Radiology",
            "state": "IN",
            "license": "01058810",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "IN",
            "license": "01058810",
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "IN",
            "license": "01058810",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200473380",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valley Emergency Physicians Inc
• Hugh J. Van Auken Sr., CP
• Katie Lynn Vanbuskirk, PHARM. D.
• Iris Vance, PT
• Travis Wayne Vander Reyden, P.T.
• Robert Vanderwal, MS, LMHC
• Robert R. Vanderzwaag Jr., M.D.
• Jerrold A Vandyke, MD
• Kathryn Susan Vansickle, M.S.CCC-SLP
• Kimberly Varga, LCSW

• Diagnostic Radiology Physician in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Diagnostic Radiology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2013; 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.