Michael Merrell Van Tienderen, DO

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

20A19832 Issued in CA

Practice address

757 Westwood PLZ Ste 3325
Los Angeles, CA 90095-2501

Phone

(310) 267-8678

NPI assigned

Sep 14, 2016

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 UT

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

Anesthesiology

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pediatric Anesthesiologists IncGroup PAC ID 4385618578, 14 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

96.47 of 100Reported as group

Quality

93.25

Promoting interoperability

100

Improvement activities

40

Cost

79.74

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mvantienderen89936@direct.med.utah.edu
• Direct secure messaging: mvantienderen1183473@direct.uclahealth.org

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 Anesthesiologists Inc

  • Anesthesiology Physician
  • Salt Lake City, UT
  • NPI 1417965799
  Medicare reassignment Care Compare group NPD
• University of Utah Adult Services

  • General Practice Physician
  • Salt Lake City, UT
  • NPI 1114321981
  Medicare reassignment NPD
• University of Utah Adult Services

  • Physical Medicine & Rehabilitation Physician
  • Salt Lake City, UT
  • NPI 1275937146
  NPD
• University of Utah Adult Services

  • Diagnostic Radiology Physician
  • Salt Lake City, UT
  • NPI 1598169419
  NPD
• Regents of the University of California

  • Anesthesiology Physician
  • Los Angeles, CA
  • NPI 1326096165
  NPD (past)

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

{
    "created_epoch": "1473811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1427506856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 WESTWOOD PLZ STE 3325",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900952501",
            "telephone_number": "310-267-8678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN TIENDEREN",
        "first_name": "MICHAEL",
        "middle_name": "MERRELL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-14",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "CA",
            "license": "20A19832",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "20A19832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MVANTIENDEREN89936@DIRECT.MED.UTAH.EDU",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Adriaan Esias Van Rensburg, MD
• Van Scoy-Mosher Miller MDS
• Michael B Van Scoy-Mosher, M.D.
• Crystal Van Sickle
• Stephanie Van Stralen, PSY.D.
• Jan Marie-Albert Van Tornout, MD
• John Derek Van Vessem IV, DO
• Jenna Van Wagner, M.S.
• Sandra Van Wijk, MS, CCC-SLP
• David Van Zak, PSY. D.

• Anesthesiology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.