Michael Ray Vandusen, D.O.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

A-2141-18 Issued in NM

Practice address

801 W Maple St
Farmington, NM 87401

Phone

(505) 609-2000

Fax

(505) 609-2259

NPI assigned

Jun 10, 2009

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 NM

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

Anesthesiology

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

San Juan Regional Medical Center, Inc.Group PAC ID 4587559505, 233 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• San Juan Regional Medical Center Inc Hospital, Farmington, NM, CCN 320005

Merit-based Incentive Payment System (MIPS)

Final score

90.97 of 100Reported as group

Quality

79.73

Promoting interoperability

100

Improvement activities

40

Cost

78.87

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• San Juan Regional Medical Center Inc

  • Gastroenterology Physician
  • Farmington, NM
  • NPI 1639662901
  Medicare reassignment Care Compare group NPD
• San Juan Regional Medical Center Inc

  • Anesthesiology Physician
  • Farmington, NM
  • NPI 1639459712
  NPD
• San Juan Regional Medical Center Inc

  • Family Medicine Physician
  • Farmington, NM
  • NPI 1710589015
  NPD

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

• San Juan Regional Medical Center Inc

  • Rehabilitation Hospital Unit
  • Farmington, NM
  • NPI 1326663592
  Care Compare affiliation
• San Juan Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Farmington, NM
  • NPI 1427058510
  Care Compare affiliation

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

{
    "created_epoch": "1244592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529884800000",
    "number": "1205062742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6210",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874996210",
            "telephone_number": "505-609-2258",
            "fax_number": "505-609-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 W MAPLE ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "87401",
            "telephone_number": "505-609-2000",
            "fax_number": "505-609-2259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDUSEN",
        "first_name": "MICHAEL",
        "middle_name": "RAY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-10",
        "last_updated": "2018-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "N9004",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NM",
            "license": "A-2141-18",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald M. Van Sickle Jr., LPCC
• Joshua Lee Vanbuskirk, D.C.
• Kyra Vanden Broeck, DDS
• Kylie Vandenberg
• Duane E Vanderslice, M.D.
• Joyce Vaughn
• Anthony Patrick Velarde, LSAA
• Pat Velarde
• Caryl Ventura
• Matthew Augustine Verstraete, D.C.

• Anesthesiology Physician in Farmington, NM
• Providers in Farmington, NM by specialty
• Anesthesiology Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2018; 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.