Douglas Lee Vander Woude, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

4301407024 Issued in MI

Practice address

220 Lyon St NW
Ste 700
Grand Rapids, MI 49503-2210

Phone

(616) 451-4500

Fax

(616) 451-9077

NPI assigned

Jun 13, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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

Plastic and Reconstructive Surgery

Education

University of Michigan Medical School, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Plastic Surgery Associates PCGroup PAC ID 1456300300, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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.

• Plastic Surgery Associates PC

  • Plastic Surgery Physician
  • Grand Rapids, MI
  • NPI 1093899767
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589155200000",
    "number": "1235133653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 LYON ST NW",
            "address_2": "STE 700",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032210",
            "telephone_number": "616-451-4500",
            "fax_number": "616-451-9077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 LYON ST NW",
            "address_2": "STE 700",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032210",
            "telephone_number": "616-451-4500",
            "fax_number": "616-451-9077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDER WOUDE",
        "first_name": "DOUGLAS",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MI",
            "license": "4301407024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joel Andrew Vander Wall, MSPT
• Elizabeth Vander Weide
• Susan Kay Vander Weide
• Karra Vander Wiere, LMSW
• Amy C Vander Woude, M.D.
• Kristin Lousise Vanderark
• Janna Vanderband, ATR-P
• Ronald Vanderbeck, PSYD
• Ethan Vanderberg
• Emily Michelle Vanderburg

• Plastic Surgery Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Plastic Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2020; 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.