NPIMap

Individual provider Active NPI

Michael P Vangrouw, PA-C

  • Physician Assistant
  • Newville, PA
National Provider Identifier
1417925413
Registry record updated Aug 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA050729 Issued in PA
Practice address
100 S High St
Newville, PA 17241-1409
Phone
(717) 776-3114
Fax
(717) 776-5020
NPI assigned
Mar 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA050729 PA Primary

Addresses

Primary practice location

100 S High St
Newville, PA 17241-1409

Mailing address

100 S High St
Newville, PA 17241-1409
Phone (717) 776-3114

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120606000011 PA Practitioner - Physician Assistant 7214937366 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Graham Medical Clinic,P.C.Group PAC ID 6103002886, 8 clinicians

Practice addresses (Care Compare)

100 S High St
Newville, PA 17241-1409
Phone (717) 776-3114

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA050729PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: michaelv@grahammedicalclinic.medentdirect.com

Organizations & group practices 2

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470873600000",
    "number": "1417925413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S HIGH ST",
            "city": "NEWVILLE",
            "state": "PA",
            "postal_code": "172411409",
            "telephone_number": "717-776-3114",
            "fax_number": "717-776-5020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S HIGH ST",
            "city": "NEWVILLE",
            "state": "PA",
            "postal_code": "172411409",
            "telephone_number": "717-776-3114",
            "fax_number": "717-776-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANGROUW",
        "first_name": "MICHAEL",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2016-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA050729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newville, PA

Sources for this page

Verify at the official NPI Registry.