Kurt Vanderveen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601004356 Issued in MI

Practice address

3434 Rivertown Point CT SW
Grandville, MI 49418-3076

Phone

(616) 257-3344

Fax

(616) 257-1491

NPI assigned

Oct 4, 2006

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

Electronic endpoints 1

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wolverine Dermatology PCGroup PAC ID 9638435191, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.55 of 100Reported as group

Quality

77.1

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: kjv0101@westmiderm.emadirect.md

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.

• Wolverine Dermatology, PC

  • Dermatology Physician
  • Wyoming, MI
  • NPI 1679085161
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1407941396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3434 RIVERTOWN POINT CT SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494183076",
            "telephone_number": "616-257-3344",
            "fax_number": "616-257-1491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 RIVERTOWN POINT CT SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494183076",
            "telephone_number": "616-257-3344",
            "fax_number": "616-257-1491"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 E Beltline Ave NE Ste 301",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495256046",
            "country_code": "US",
            "telephone_number": "616-942-9343",
            "fax_number": "616-942-2538",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3290 N Wellness Dr Ste 240",
            "address_purpose": "LOCATION",
            "city": "Holland",
            "state": "MI",
            "postal_code": "494247261",
            "country_code": "US",
            "telephone_number": "616-395-9379",
            "fax_number": "616-820-1457",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDERVEEN",
        "first_name": "KURT",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "5601004356",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "KJV0101@westmiderm.emadirect.md",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "3434 Rivertown Point Ct SW",
            "city": "Grandville",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494183076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Luke Vander Wal, PSY.D
• Aurora Neeson Vanderhart, LHIS
• Tamera Vanderlind, MA., LPC
• James H Vandermay, LMSW
• Kayla Vanderstel, MD
• Ronda Lynn Vanderwall, DC
• Cassi Vandewater
• Meghan Vandewater, CCC-SLP, C/NDT
• Janet Beth Vandusen, PT
• Jennifer Vaneyk

• Physician Assistant in Grandville, MI
• Providers in Grandville, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 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.