Royce J. Vandervort, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN536104 Issued in PA

Practice address

1307 Federal St
Suite 101
Pittsburgh, PA 15212-4705

Phone

(412) 231-6550

Fax

(412) 231-6697

NPI assigned

Jun 15, 2006

Last updated

Aug 5, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in PA, OH2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Gastroenterology Clinic and Endoscopy Center IncGroup PAC ID 3274429477, 36 clinicians

Steel City Anesthesia, LLCGroup PAC ID 4789634221, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• TLC Home Healthcare LLC

  • Home Health Agency
  • Warren, OH
  • NPI 1568018067

  5% Or Greater Direct Ownership Interest, W-2 Managing Employee

  CMS ownership

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.

• The Gastroenterology Clinic & Endoscopy Center Inc

  • Gastroenterology Physician
  • Warren, OH
  • NPI 1952497117

  PA

  Medicare reassignment Care Compare group NPD
• Steel City Anesthesia, LLC

  • Certified Registered Nurse Anesthetist
  • Pittsburgh, PA
  • NPI 1730126632
  Medicare reassignment Care Compare group
• Allegheny Clinic

  dba AHN-Primary Care Bethel Park

  • Family Medicine Physician
  • Bethel Park, PA
  • NPI 1073081493
  Medicare reassignment NPD
• Northstar Anesthesia of Ohio LLC

  • Anesthesiology Physician
  • Springfield, OH
  • NPI 1417276429
  Medicare reassignment NPD
• Optimum Anesthesia

  • Anesthesiology Physician
  • Poland, OH
  • NPI 1851656854
  Medicare reassignment
• Allegheny Clinic

  dba AHN Primary Care Mobile Clinic

  • Primary Care Clinic/Center
  • Pittsburgh, PA
  • NPI 1215752548
  NPD
• Allegheny Clinic

  dba Allegheny General Anesthesia

  • Anesthesiology Physician
  • Pittsburgh, PA
  • NPI 1558310326
  NPD
• TLC Home Healthcare LLC

  • Home Health Agency
  • Warren, OH
  • NPI 1568018067
  NPD
• McCandless Endoscopy Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Pittsburgh, PA
  • NPI 1336324045
  NPD (past)
• Western Pennsylvania Anesthesia Associates, LTD.

  • Pain Medicine (Anesthesiology) Physician
  • Pittsburgh, PA
  • NPI 1386639847
  NPD (past)

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564963200000",
    "number": "1346284817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4135 BOARDMAN CANFIELD RD",
            "address_2": "SUITE 101",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444069803",
            "telephone_number": "330-286-5330",
            "fax_number": "330-286-5396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 FEDERAL ST",
            "address_2": "SUITE 101",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152124705",
            "telephone_number": "412-231-6550",
            "fax_number": "412-231-6697"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9335 McKnight Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152375928",
            "country_code": "US",
            "telephone_number": "412-367-1064",
            "fax_number": "412-367-1359",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDERVORT",
        "first_name": "ROYCE",
        "middle_name": "J.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2019-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "RN239247",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN536104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11929464",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019763430008",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "8232124",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "074629TV6",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2418379",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark David Vanderbilt, M.D.
• Beverly June Vanderhorst
• Kathleen Vanderkolk
• Benjamin Vanderschelden, MD
• Donna Vanderveen
• Robert Vanderweele
• Marjke Vanderzee
• Reed William Vandeusen, MD
• Trent Sebastian Vandevort, PT, DPT, LAT, ATC
• Lindsey Vandling

• Certified Registered Nurse Anesthetist in Pittsburgh, PA
• Providers in Pittsburgh, PA by specialty
• Certified Registered Nurse Anesthetist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.