Individual provider Active NPI

Kristi L. Vanderkolk, M.D.

  • Family Medicine Physician
  • Kalamazoo, MI
National Provider Identifier
1245469428
Registry record updated Dec 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301094468 Issued in MI
Practice address
117 W Paterson St
Kalamazoo, MI 49007-2557
Phone
(269) 349-2641
NPI assigned
Jul 8, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 4301094468 MI Primary

Addresses

Primary practice location

117 W Paterson St
Kalamazoo, MI 49007-2557

Mailing address

117 W Paterson St
Kalamazoo, MI 49007-2557
Phone (269) 349-2641

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130219000164 MI Practitioner - Family Practice 3971758186 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wayne State University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Michigan University School of MedicineGroup PAC ID 7517113954, 76 clinicians

Practice addresses (Care Compare)

555 W Crosstown Pkwy
200 Wmed Health
Kalamazoo, MI 49008-1999
Phone (269) 337-6500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.1 of 100Reported as group
Quality
85.82
Promoting interoperability
100
Improvement activities
40
Cost
77.4

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301094468MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Center Inc CurrentSince Dec 22, 2012 Accepting new patients
Western Michigan University School of Medicine CurrentSince Feb 1, 2013 Accepting new patients
Michigan State University Kalamazoo Center for Medical Studies Current Accepting new patients
Family Health Center Inc CurrentSince Dec 22, 2012 Accepting new patients
Bronson Methodist Hospital Past Accepting new patients

Locations

117 W Paterson St
Kalamazoo, MI 49007

1000 Oakland Dr
Kalamazoo, MI 49008
Phone (269) 337-4347

505 E Alcott St
Kalamazoo, MI 49001
Phone 2693492641 ext. 715

555 W Crosstown Pkwy
Ste 200
Kalamazoo, MI 49008
Phone (269) 337-6500

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1247011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513036800000",
    "number": "1245469428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 W PATERSON ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490072557",
            "telephone_number": "269-349-2641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 W PATERSON ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490072557",
            "telephone_number": "269-349-2641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERKOLK",
        "first_name": "KRISTI",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-08",
        "last_updated": "2017-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301094468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.