NPIMap

Individual provider Active NPI

Sarah L Thordarson, MD

  • Physical Medicine & Rehabilitation Physician
  • Watervliet, MI
National Provider Identifier
1275196933
Registry record updated Jun 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
4301509849 Issued in MI
Practice address
400 Medical Park Dr
Watervliet, MI 49098-9225
Phone
(269) 463-2242
NPI assigned
Apr 18, 2019
Last updated
Jun 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 4301509849 MI Primary

Addresses

Primary practice location

400 Medical Park Dr
Watervliet, MI 49098-9225

Mailing address

400 Medical Park Dr
Watervliet, MI 49098-9225

Other names 1

  • Sarah L Heczko Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230802000670 MI Practitioner - Physical Medicine and Rehabilitation 2062873474 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1234 Napier Ave
Corewell Health Lakeland Hospitals
Saint Joseph, MI 49085-2112
Phone (269) 983-8300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301509849MIMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Community Hospital Watervliet Current Accepting new patients
Pathology Assoc of Southwestern Michigan, PC Current Accepting new patients
Lakeland Hospitals at Niles and St Joseph, Inc CurrentSince Jul 13, 2023 Accepting new patients
Lakeland Community Hospital Watervliet CurrentSince Jul 13, 2023 Accepting new patients
Lakeland Hospitals at Niles and St Joseph, Inc CurrentSince Jul 13, 2023 Accepting new patients
Lakeland Community Hospital Watervliet CurrentSince Jul 13, 2023 Accepting new patients
Lakeland Community Hospital Watervliet Past Accepting new patients
Community Hospital Past Accepting new patients

Locations

7040 Red Arrow Hwy
Coloma, MI 49038
Phone (269) 468-4318

1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941

400 Medical Park Dr
Watervliet, MI 49098
Phone (269) 463-3111

460 Medical Park Dr
Ste 200
Watervliet, MI 49098

Interoperability endpoints

  • FHIR API: https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/
  • Direct secure messaging: sthordarson1680993@epic00.corewelldirect.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1555545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686441600000",
    "number": "1275196933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MEDICAL PARK DR",
            "city": "WATERVLIET",
            "state": "MI",
            "postal_code": "490989225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MEDICAL PARK DR",
            "city": "WATERVLIET",
            "state": "MI",
            "postal_code": "490989225",
            "telephone_number": "269-463-2242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORDARSON",
        "first_name": "SARAH",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-18",
        "last_updated": "2023-06-11",
        "certification_date": "2023-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "4301509849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "HECZKO",
            "middle_name": "L",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Watervliet, MI

Sources for this page

Verify at the official NPI Registry.