Philip H Vanderstoep, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

22588 Issued in MN

Practice address

1990 Connecticut Ave S
Sartell, MN 56377-2554

Phone

(320) 257-5595

Fax

(320) 257-5596

NPI assigned

Jul 28, 2005

Last updated

Aug 12, 2011By 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 1

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Central Imaging LLC

  dba Alliance Imaging

  • Diagnostic Radiology Physician
  • Saint Cloud, MN
  • NPI 1457967234
  NPD (past)
• Minnesota Radiology Institute

  • Diagnostic Radiology Physician
  • Crosby, MN
  • NPI 1982783148
  NPD (past)

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313107200000",
    "number": "1386644730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7366",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563027366",
            "telephone_number": "320-257-5595",
            "fax_number": "320-257-5596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 CONNECTICUT AVE S",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563772554",
            "telephone_number": "320-257-5595",
            "fax_number": "320-257-5596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERSTOEP",
        "first_name": "PHILIP",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2011-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "22588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300039116",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "965251008761",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP25529",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARAZ/ AMERICA'S PPO",
            "identifier": "26650",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "54886VA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "16-29701",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREATWEST HEALTHCARE",
            "identifier": "411772562",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104072300",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE OF MINNESOTA",
            "identifier": "106088C561",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexander Twohy
• Ben Edet Ukitetuh
• Unbound Psychiatry PLC
• Jessica Marie Vagle, APRN CNS-BC FNP-BC
• Vandalia Health, PLLC (Dr. Green)
• Stephen D Vang, PA-C
• Brent David Venables, D.C.
• Sofia Margaret Villalobos
• Alan J. Voegele, PA-C
• Aden Vollen

• Diagnostic Radiology Physician in Sartell, MN
• Providers in Sartell, MN by specialty
• Diagnostic Radiology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2011; 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.