Individual provider Active NPI

Nicholas Gunnar Van Maele, MD

  • Otolaryngology Physician
  • Grand Rapids, MI
National Provider Identifier
1457810251
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
4301511135 Issued in MI
Practice address
4055 Cascade Rd SE
Grand Rapids, MI 49546-2149
Phone
(616) 252-5760
NPI assigned
Mar 19, 2019
Last updated
Dec 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 4301511135 MI Primary

Addresses

Primary practice location

4055 Cascade Rd SE
Grand Rapids, MI 49546-2149

Mailing address

4055 Cascade Rd SE
Grand Rapids, MI 49546-2149
Phone (616) 252-5760

Other practice location 1

2093 Health Dr SW
Wyoming, MI 49519-9691
Phone (616) 252-5760

Other practice location 2

5900 Byron Center Ave SW
Wyoming, MI 49519-9606
Phone (616) 252-5760

Other practice location 3

3565 S State Rd
Ionia, MI 48846-9416
Phone (616) 523-1400

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
I20240926000765 MI Practitioner - Otolaryngology 9931583689 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Central Michigan College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metropolitan HospitalGroup PAC ID 5597651836, 421 clinicians

Practice addresses (Care Compare)

5900 Byron Ctr Ave SW
Wyoming, MI 49519-9606
Phone (616) 252-7200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.92
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sparrow Ionia Hospital CurrentSince Jan 1, 2025 Accepting new patients
Sparrow Ionia Hospital CurrentSince Jan 1, 2025 Accepting new patients
Sparrow Ionia Hospital Current Accepting new patients
Metropolitan Hospital CurrentSince Sep 1, 2024 Accepting new patients
Metropolitan Hospital Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

4055 Cascade Rd SE
Grand Rapids, MI 49546
Phone (616) 252-4410

3565 S State Rd
Ionia, MI 48846
Phone (616) 523-1498

550 E Washington St
Ionia, MI 48846
Phone (616) 523-1600

5900 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 252-3243

5950 Metro Way SW
Wyoming, MI 49519
Phone (616) 252-8100

Interoperability endpoints

  • Direct secure messaging: nvanmaele18703@ukhcdirect.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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1457810251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4055 CASCADE RD SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462149",
            "telephone_number": "616-252-5760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4055 CASCADE RD SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462149",
            "telephone_number": "616-252-5760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2093 Health Dr SW",
            "address_purpose": "LOCATION",
            "city": "Wyoming",
            "state": "MI",
            "postal_code": "495199691",
            "country_code": "US",
            "telephone_number": "616-252-5760",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5900 Byron Center Ave SW",
            "address_purpose": "LOCATION",
            "city": "Wyoming",
            "state": "MI",
            "postal_code": "495199606",
            "country_code": "US",
            "telephone_number": "616-252-5760",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3565 S State Rd",
            "address_purpose": "LOCATION",
            "city": "Ionia",
            "state": "MI",
            "postal_code": "488469416",
            "country_code": "US",
            "telephone_number": "616-523-1400",
            "fax_number": "616-523-1497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN MAELE",
        "first_name": "NICHOLAS",
        "middle_name": "GUNNAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-19",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": "4301511135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.