Kevin Anh Tai Van, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4351054412 Issued in MI

Practice address

16815 E Jefferson Ave Ste 120
Grosse Pointe, MI 48230-1923

Phone

(586) 498-4400

NPI assigned

Jun 4, 2025

Last updated

Jun 4, 2025By the provider in NPPES

Sex

Male

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1748995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1275427395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 W ROBERT AVE",
            "city": "HAZEL PARK",
            "state": "MI",
            "postal_code": "480303223",
            "telephone_number": "303-475-6054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16815 E JEFFERSON AVE STE 120",
            "city": "GROSSE POINTE",
            "state": "MI",
            "postal_code": "482301923",
            "telephone_number": "586-498-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN",
        "first_name": "KEVIN",
        "middle_name": "ANH TAI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-04",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4351054412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsay Ann Trepanowski, PT, DPT
• Linda M Twomey, R.N., APRN
• Alisha Ungkuldee, DO
• Uplift Family Services
• Shawna Marie Urban, M.S., CCC-SLP
• Jaime L. Vande Veegaete, D.C.
• Janet G Ventimiglia, PT
• Edward John Vermet, DDS
• Johanna Jacoba Verwilghen, MD
• Allison Vorce, PA-C

• Family Medicine Physician in Grosse Pointe, MI
• Providers in Grosse Pointe, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.