Jon Vandervliet, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

4301092851 Issued in MI

Practice address

2006 Hogback Rd
Suite 5a
Ann Arbor, MI 48105-9750

Phone

(734) 786-2317

Fax

(734) 786-4977

NPI assigned

Jun 23, 2008

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 3

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

Specialty

Anesthesiology

Education

Michigan State University College of Human Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anesthesia Associates of Ann Arbor PLLCGroup PAC ID 1355317223, 213 clinicians

Huron Gastroenterology Associates PCGroup PAC ID 0840288221, 95 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156
• Chelsea Hospital Hospital, Chelsea, MI, CCN 230259
• Trinity Health Livingston Hospital Hospital, Howell, MI, CCN 230069

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Anesthesia Associates of Ann Arbor, PLLC

  • Anesthesiology Physician
  • Westland, MI
  • NPI 1669581997
  Medicare reassignment Care Compare group NPD
• Huron Gastroenterology Associates PC

  • Gastroenterology Physician
  • Ypsilanti, MI
  • NPI 1144335639

  Anesthesiology

  Medicare reassignment Care Compare group NPD
• Center for Digestive Care LLC

  • Ambulatory Surgical Clinic/Center
  • Ypsilanti, MI
  • NPI 1164528527
  Medicare reassignment NPD
• Huron Gastroenterology Associates PC

  • Gastroenterology Physician
  • Howell, MI
  • NPI 1265635593
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Saint Joseph Mercy Livingston Hospital

  • General Acute Care Hospital
  • Brighton, MI
  • NPI 1093748642
  Care Compare affiliation
• St Joseph Mercy Chelsea Inc

  dba Chelsea Hospital

  • General Acute Care Hospital
  • Chelsea, MI
  • NPI 1992761985
  Care Compare affiliation
• St Joseph Mercy Hospital

  dba Trinity Heath Ann Arbor Hospital

  • General Acute Care Hospital
  • Ypsilanti, MI
  • NPI 1780658443
  Care Compare affiliation

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367798400000",
    "number": "1366603318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2006 HOGBACK RD",
            "address_2": "SUITE 5A",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059750",
            "telephone_number": "734-786-2317",
            "fax_number": "734-786-4977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 HOGBACK RD",
            "address_2": "SUITE 5A",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059750",
            "telephone_number": "734-786-2317",
            "fax_number": "734-786-4977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERVLIET",
        "first_name": "JON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-23",
        "last_updated": "2013-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301092851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "H17604112",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN LICENSE",
            "identifier": "4301092851",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366603318",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor Vandenberg
• Mark Thomas Vander Lugt, M.D.
• Stuart Vanderheide, MD
• Douglas Vanderlooven, LMSW
• Stacie Dawn Vanderver
• Sean S Vanderwaal
• Gina K Vanduinen, LMSW
• Rebecca W Vandyke, MD
• Yexenia Vanegas
• Jeremy Scott Vanepps, MD

• Anesthesiology Physician in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Anesthesiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2013; 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.