Leon Vanderlaan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601001241 Issued in MI

Practice address

1108 W State St
Hastings, MI 49058-9711

Phone

(269) 948-3102

Fax

(269) 948-5891

NPI assigned

May 25, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Advantage Health Physicians PC

  • Family Medicine Physician
  • Grand Rapids, MI
  • NPI 1386695252
  NPD (past)
• Pennock Hospital

  • Family Medicine Physician
  • Hastings, MI
  • NPI 1518186295
  NPD (past)

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494806400000",
    "number": "1275589913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE MC-845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-486-6790",
            "fax_number": "616-486-6702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 W STATE ST",
            "city": "HASTINGS",
            "state": "MI",
            "postal_code": "490589711",
            "telephone_number": "269-948-3102",
            "fax_number": "269-948-5891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERLAAN",
        "first_name": "LEON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2017-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601001241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM - BRONSON URGENT CARE",
            "identifier": "1104840529",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meredith Trumbull, LMSW
• Stacy A Uebele, D.P.M.
• Kayla Vander Haar, LPC
• Alisha Vander Ploeg, LMSW
• Deloris K Vanderhoof, CRNA
• Amy Vanzandt, COMM. HEALTH WORKER
• Halina Vaughan, BS-MCH, IBCLC
• Sarah E Verburg, FNP
• Vicki L Shumaker PLC
• Ashley Villegas

• Physician Assistant in Hastings, MI
• Providers in Hastings, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.