Mary Elizabeth Van Der Velde, MD

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

4301082862 Issued in MI

Practice address

1500 E Medical Center Dr
Ann Arbor, MI 48109-5000

Phone

(734) 647-5299

NPI assigned

Aug 2, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Regents of the University of Michigan

  • Internal Medicine Physician
  • Ann Arbor, MI
  • NPI 1205868353

  Pediatrics

  Medicare reassignment NPD
• Regents of the University of Michigan

  • Pediatric Cardiology Physician
  • Ann Arbor, MI
  • NPI 1659305514

  Pediatrics

  NPD
• Regents of the University of Michigan

  • Specialty Pharmacy
  • Dexter, MI
  • NPI 1952181919
  NPD
• Boston Childrens Heart Foundation Inc

  • Pediatric Cardiology Physician
  • Boston, MA
  • NPI 1982680922

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1194732867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095000",
            "telephone_number": "734-647-5299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 East Medical Center Dr",
            "address_2": "11th floor CS Mott Childrens Hospital Room 661",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481095204",
            "country_code": "US",
            "telephone_number": "734-764-5176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN DER VELDE",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301082862",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MI",
            "license": "4301082862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4560087",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valor Physical Therapy
• Joanna Van Beek, M.D.
• Pamela Marie Van Buren, OCCUPATIONAL THERAPI
• Cosmas J M Van de Ven, MD
• Abraham F Van Der Spek, MD
• Hannah Rose Van Galder, MD
• Bethany Weaver Van Helden, MS, RD
• Alanna Battersby Van Hooser, M.D.
• Julie Elizabeth Van Hove, RN
• Jessica L Van Huysse, PHD

• Pediatric Cardiology Physician in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Pediatric Cardiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.