Marie Cassandre O Vandervoord

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

4704325239 Issued in MI

Practice address

3555 W 13 Mile Rd
Royal Oak, MI 48073-6710

Phone

(248) 551-3302

NPI assigned

Dec 11, 2018

Sex

Female

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mvandervoord1259930@epic00.shdirect.org
• Direct secure messaging: mmacdonnell3390030@direct.beaumont.edu

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.

• Beaumont Medical Group- Specialty Services

  • Surgery Physician
  • Royal Oak, MI
  • NPI 1578072906
  Medicare reassignment NPD
• Lo&Fritz LLC

  dba Rooted Health Collective

  • Family Nurse Practitioner
  • Clarkston, MI
  • NPI 1336033067
  NPD Authorized official
• William Beaumont Hospital

  • Physician Assistant
  • Royal Oak, MI
  • NPI 1164471983
  NPD (past)

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

{
    "created_epoch": "1544486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1487125829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 W 13 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736710",
            "telephone_number": "248-551-3302"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1060 S Van Dyke Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Bad Axe",
            "state": "MI",
            "postal_code": "484139638",
            "country_code": "US",
            "telephone_number": "989-269-7775",
            "fax_number": "989-269-7677",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1777 Axtell Dr Ste 202",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480844435",
            "country_code": "US",
            "telephone_number": "248-594-3142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDERVOORD",
        "first_name": "MARIE CASSANDRE",
        "middle_name": "O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-11",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MI",
            "license": "4704325239",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704325239",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmacdonnell3390030@direct.beaumont.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1777 Axtell Dr Ste 202",
            "city": "Troy",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480844435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Khanh Van
• Laurie Marie Vance, M.D.
• Courtney Lee Vander Werp, OTR/L
• Mark Vanderkaay, DDS
• Merry Vanderlinden, P.A.
• Cynthia L Vanderweel, CMT
• Vandutch Medsurg PLLC (VanDutch Orthoplastic Foot & Ankle)
• Jacqueline Renee Vaneecke, PT
• Panhia Vang, LLPC
• Erica Vanhook

• Pediatric Nurse Practitioner in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Pediatric Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.