Nathan Vandjelovic

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

5101020558 Issued in MI

Practice address

4201 Saint Antoine St # 9C
Detroit, MI 48201-2153

Phone

(313) 745-5147

Fax

(313) 966-0880

NPI assigned

Mar 3, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in NY

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

Otolaryngology

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Rochester Pediatric Otolaryngology AssociatesGroup PAC ID 7719040369, 5 clinicians

Pediatric Allergy of PulmonaryGroup PAC ID 8628052057, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Strong Memorial Hospital Hospital, Rochester, NY, CCN 330285

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nvandjelovic183568@direct.urmc.rochester.edu

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.

• Pediatric Allergy of Pulmonary

  • Pediatric Pulmonology Physician
  • Rochester, NY
  • NPI 1013952688
  Medicare reassignment Care Compare group NPD
• University of Rochester Pediatric Otolaryngology Associates

  • Pediatric Otolaryngology Physician
  • Rochester, NY
  • NPI 1295984532
  Medicare reassignment Care Compare group NPD
• University of Rochester

  • Internal Medicine Physician
  • Rochester, NY
  • NPI 1710226824
  Medicare reassignment NPD
• Acute Care Trauma of the University of Rochester

  • Surgical Critical Care Physician
  • Rochester, NY
  • NPI 1851754634
  NPD
• Cardiac Surgery of the University of Rochester

  • Surgical Critical Care Physician
  • Rochester, NY
  • NPI 1689023277
  NPD
• University of Rochester

  dba Strong Memorial Hospital-University of Rochester

  • Community/Retail Pharmacy
  • Rochester, NY
  • NPI 1598476269
  NPD
• University of Rochester

  dba Strong Memorial Hospital MD Group

  • Internal Medicine Physician
  • Rochester, NY
  • NPI 1821152588
  NPD
• DMC Education & Research

  • Physician Assistant
  • Detroit, MI
  • NPI 1235444969
  NPD (past)

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

• University of Rochester

  dba Strong Memorial Hospital

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1346285657
  Care Compare affiliation
• University of Rochester

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1669126090
  Care Compare affiliation

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

{
    "created_epoch": "1362268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1396086286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875S BRYS DR",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482361209",
            "telephone_number": "804-929-2964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST # 9C",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-745-5147",
            "fax_number": "313-966-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDJELOVIC",
        "first_name": "NATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-03",
        "last_updated": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "NY",
            "license": "297940",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": "5101020558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nvandjelovic183568@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nvandjelovic183568@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anna Vanderschaegen
• Lori Vanderwill
• Matthew Vanderwindt, LCSW
• Victoria Vanderziel-Fultz
• Nick Vandiver
• Vandyke Medical Clinic Management Corp
• Carole Vandyke, P.A.
• Karra Ann Vanfleteren, NNP
• Ashley Vang
• Stephen J Vangel, PHD

• Otolaryngology Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Otolaryngology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; 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.