Katherine L Vanderlaan, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5601006240 Issued in MI

Practice address

2700 Robert T Longway Blvd Ste B
Flint, MI 48503-2190

Phone

(810) 235-2004

Fax

(810) 235-2841

NPI assigned

Mar 8, 2012

Sex

Female

Sole proprietor

Yes

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physician Coverage Services PCGroup PAC ID 3678536398, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kvanderlaan4330@direct.hurleymc.com

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.

• Physician Coverage Services PC

  • Internal Medicine Physician
  • Flint, MI
  • NPI 1669567806
  Medicare reassignment Care Compare group
• Hurley Health Services

  • Family Medicine Physician
  • Clio, MI
  • NPI 1558302497

  Physician Assistant

  Medicare reassignment NPD
• Physician Coverage Services

  • Specialist
  • Grand Blanc, MI
  • NPI 1992868459
  NPD (past)

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

{
    "created_epoch": "1331164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331164800000",
    "number": "1255605283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 ROBERT T LONGWAY BLVD STE B",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485032190",
            "telephone_number": "810-235-2004",
            "fax_number": "810-235-2841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 ROBERT T LONGWAY BLVD STE B",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485032190",
            "telephone_number": "810-235-2004",
            "fax_number": "810-235-2841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERLAAN",
        "first_name": "KATHERINE",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-08",
        "last_updated": "2012-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601006240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Edward Vanbuskirk, LLMSW
• Joshua Vance
• Angela Marie Vancleve, OTR/L
• James Vandergriff
• Ronald Vanderklok
• Bailey Vanderweel, LMSW
• Judy K. Vandyke, CNP
• Laurie Ann Vandyke, M.A., CCC-A
• Serrina Elaine Vaneckhoutte, FNP
• Nicole Ann Vanepps, PA-C

• Medical Physician Assistant in Flint, MI
• Providers in Flint, MI by specialty
• Medical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2012; 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.