Mahlon Vandelden, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

101110 Issued in MO

Practice address

1000 W Nifong Blvd
Building 3, Suite 100
Columbia, MO 65203-5615

Phone

(573) 214-2000

Fax

(573) 214-2042

NPI assigned

Oct 17, 2005

Last updated

Feb 17, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in MO

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

Otolaryngology

Education

University of Texas Southwestern Medical School at Dallas, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Boone Hospital Center Hospital, Columbia, MO, CCN 260068

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

• CH Allied Services, Inc

  dba Boone Hospital Center

  • Cardiac Rehabilitation Clinic/Center
  • Columbia, MO
  • NPI 1548734734

  Hospital

  Care Compare affiliation
• CH Allied Services, Inc.

  dba Boone Hospital Center

  • General Acute Care Hospital
  • Columbia, MO
  • NPI 1902817844
  Care Compare affiliation

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297900800000",
    "number": "1225027907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W NIFONG BLVD",
            "address_2": "BUILDING 3, SUITE 100",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652035615",
            "telephone_number": "573-214-2000",
            "fax_number": "573-214-2042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W NIFONG BLVD",
            "address_2": "BUILDING 3, SUITE 100",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652035615",
            "telephone_number": "573-214-2000",
            "fax_number": "573-214-2042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDELDEN",
        "first_name": "MAHLON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2011-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IN",
            "license": "01048581A",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "KY",
            "license": "34110",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MO",
            "license": "101110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "065102",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00153580",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000045661",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000045661",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "040013796",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64341019",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "382908",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200181080A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karra Jennifer Van Landuyt, PT
• Margaret Julia Van Loo, FNP-BC
• Miranda Van Norman, RBT
• John Charles Van Stone, M.D.
• Tyson Vandagriff, M.D.
• Paula Ann Vandelicht, R.D. L.D.
• Deanette Vanderbur
• Abbey Vandermillion, LCSW
• Mark Lewis Vandewalker, M.D.
• Deana Christina Vandivier, CRNA

• Otolaryngology Physician in Columbia, MO
• Providers in Columbia, MO by specialty
• Otolaryngology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2011; 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.