Active NPI
James Michael Vandaele, PA-C
- Physician Assistant
- Beverly Hills, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601008593
- Practice address
- 17877 W 14 Mile Rd
Beverly Hills, MI 48025 - Phone
- (248) 644-3920
- Fax
- (248) 644-2569
- NPI assigned
- May 4, 2015
- Last updated
- Aug 3, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601008593 | MI | Primary |
| Surgical Physician Assistant | 363AS0400X | 018604 | NY | |
| Surgical Physician Assistant | 363AS0400X | 5601008593 | MI |
Addresses
Primary practice location
17877 W 14 Mile Rd
Beverly Hills, MI 48025
Mailing address
17877 W 14 Mile Rd
Beverly Hills, MI 48025-3127
Phone (248) 644-3920
Other practice location 1
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600
Other practice location 2
15855 19 Mile Rd
Clinton Township, MI 48038-3504
Phone (586) 263-2300
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5601008593 | Other | MI | PHYSICIAN ASSISTANT LICENSE FOR THE STATE OF MICHIGAN |
| 5315090542 | Other | MI | CONTROLLED SUBSTANCE LICENSE |
Medicare participation
Medicare enrollment files- 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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Mercy College, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
12150 30 Mile Rd
Suite 201
Washington Township, MI 48095-2035
Phone (586) 336-2380
15717 15 Mile Rd
Clinton Township, MI 48035-2101
15855 19 Mile Rd
Clinton Township, MI 48038-3504
Phone (586) 263-2300
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601008593 | MI | MD | Physician Assistant |
| 018604 | NY | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Henry Ford Macomb Hospital Corporation | Current | Accepting new patients | |
| Henry Ford Macomb Hospital Corporation | Current | Accepting new patients | |
| Michigan Orthopaedic Surgeons, PLLC | Current | Accepting new patients | |
| Henry Ford Health System | Physician Assistant | Current | Accepting new patients |
| Henry Ford Health System | Current | Accepting new patients |
Locations
17877 W 14 Mile Rd
Beverly Hills, MI 48025
Phone (248) 644-3920
15717 15 Mile Rd
Clinton Twp, MI 48035
Phone (586) 285-3800
15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300
2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062
Interoperability endpoints
- jvandaele883606@direct.hfhs.org
Organizations & group practices 5
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.
-
- Physician Assistant
- Detroit, MI
- NPI 1811073901
-
dba Henry Ford Macomb Family Medicine
- Family Medicine Physician
- Clinton TWP, MI
- NPI 1134265986
-
- Community/Retail Pharmacy
- Plymouth, MI
- NPI 1942931720
-
dba Henry Ford Health Macomb Hospital
- General Acute Care Hospital
- Clinton TWP, MI
- NPI 1023114634
-
- Orthopaedic Surgery Physician
- Southfield, MI
- NPI 1306394309
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Detroit, MI
- NPI 1134144801
-
dba Henry Ford Health Macomb Hospital
- General Acute Care Hospital
- Clinton TWP, MI
- NPI 1023114634
-
- General Acute Care Hospital
- Warren, MI
- NPI 1902842735
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691020800000",
"number": "1396122883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17877 W 14 MILE RD",
"city": "BEVERLY HILLS",
"state": "MI",
"postal_code": "480253127",
"telephone_number": "248-644-3920",
"fax_number": "248-644-2569"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17877 W 14 MILE RD",
"city": "BEVERLY HILLS",
"state": "MI",
"postal_code": "48025",
"telephone_number": "248-644-3920",
"fax_number": "248-644-2569"
}
],
"practiceLocations": [
{
"address_1": "2799 W Grand Blvd",
"address_purpose": "LOCATION",
"city": "Detroit",
"state": "MI",
"postal_code": "482022608",
"country_code": "US",
"telephone_number": "313-916-2600",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "15855 19 Mile Rd",
"address_purpose": "LOCATION",
"city": "Clinton Township",
"state": "MI",
"postal_code": "480383504",
"country_code": "US",
"telephone_number": "586-263-2300",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VANDAELE",
"first_name": "JAMES",
"middle_name": "MICHAEL",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-05-04",
"last_updated": "2023-08-03",
"certification_date": "2023-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601008593",
"primary": true
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "NY",
"license": "018604",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "MI",
"license": "5601008593",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICIAN ASSISTANT LICENSE FOR THE STATE OF MICHIGAN",
"identifier": "5601008593",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONTROLLED SUBSTANCE LICENSE",
"identifier": "5315090542",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Beverly Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.