Individual provider Active NPI

Richard Alan Vandyken, MD

  • Internal Medicine Physician
  • Grand Rapids, MI
National Provider Identifier
1437198918
Registry record updated Sep 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301054327 Issued in MI
Practice address
426 Michigan St NE
Grand Rapids, MI 49503-5609
Phone
(616) 267-8338
NPI assigned
Jun 6, 2006
Last updated
Sep 1, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301054327 MI Primary

Addresses

Primary practice location

426 Michigan St NE
Grand Rapids, MI 49503-5609

Mailing address

100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560

Other names 1

  • Richard Alan Van Dyken Other name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040928001097 MI Practitioner - Internal Medicine 3072582832 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301054327MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baxter Community Center CurrentSince Dec 21, 2010 Accepting new patients
Spectrum Health Primary Care Partners Internal Medicine Current Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jan 1, 2011 Accepting new patients
Spectrum Health Primary Care Partners Internal Medicine CurrentSince Jan 1, 2011 Accepting new patients

Locations

100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

1300 Michigan St NE
Ste 103
Grand Rapids, MI 49503
Phone (616) 459-8338

2249 Wealthy St SE
Ste 110
Grand Rapids, MI 49506
Phone (616) 391-4600

2332 Alpine Ave NW
Grand Rapids, MI 49544
Phone (616) 363-3311

426 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 267-7888

935 Baxter St SE
Grand Rapids, MI 49506
Phone (616) 456-5310

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

4310 Leonard St NW
Ste 103
Walker, MI 49534
Phone (616) 453-0600

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1437198918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC 845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035609",
            "telephone_number": "616-267-8338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDYKEN",
        "first_name": "RICHARD",
        "middle_name": "ALAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301054327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RICHARD",
            "last_name": "VAN DYKEN",
            "middle_name": "ALAN",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.