Active NPI
Paul Joseph Vandekoppel, MD
- Emergency Medicine Physician
- Bloomington, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 01088496A
- Practice address
- 2651 E Discovery Pkwy
Bloomington, IN 47408-9059 - Phone
- (812) 353-9515
- NPI assigned
- May 29, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 52464 | SC | |
| Emergency Medicine Physician | 207P00000X | 01088496A | IN | Primary |
Addresses
Primary practice location
2651 E Discovery Pkwy
Bloomington, IN 47408-9059
Mailing address
250 N Shadeland Ave
Indianapolis, IN 46219-4959
Other practice location 1
14 Richland Medical Park Dr Ste 350
Columbia, SC 29203-6896
Phone (803) 434-7088
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 524640 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC, IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258
2651 E Discovery Pkwy
Bloomington, IN 47408-9059
Phone (812) 353-9250
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Indiana University Health Southern Indiana Physicians, LLC | Emergency Medicine | Current | Accepting new patients |
| Indiana University Health Southern Indiana Physicians LLC | Current | Accepting new patients | |
| Iu Health Medical Group, LLC | Current | Accepting new patients | |
| Prisma Health-Midlands | Current | Accepting new patients | |
| Prisma Health-Midlands | Emergency Medicine | Current | Accepting new patients |
| McLeod Health Cheraw | Emergency Medicine | Current | Accepting new patients |
| McLeod Health Cheraw | Current | Accepting new patients |
Locations
2651 E Discovery Pkwy
Bloomington, IN 47408
Phone (812) 353-9147
727 W 2nd St
Bloomington, IN 47403
Phone (812) 353-3450
250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174
1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754
711 Chesterfield Hwy
Cheraw, SC 29520
Phone (843) 320-3304
1330 Taylor St
Ste 100
Columbia, SC 29201
Phone (803) 434-6410
400 Palmetto Health Pkwy
Columbia, SC 29212
Phone (803) 296-5579
555 E Cheves St
Florence, SC 29506
Phone (843) 662-5233
300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615
Organizations & group practices 7
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.
-
- Multi-Specialty Clinic/Center
- Bloomington, IN
- NPI 1013953983
Emergency Medicine
-
- General Practice Physician
- Indianapolis, IN
- NPI 1326893777
-
- Certified Registered Nurse Anesthetist
- Cheraw, SC
- NPI 1275912974
Emergency Medicine
-
- General Acute Care Hospital
- Columbia, SC
- NPI 1205889458
-
- Durable Medical Equipment & Medical Supplies
- Bloomington, IN
- NPI 1063179844
-
- Rural Health Clinic/Center
- Darlington, SC
- NPI 1003410903
-
- Emergency Medicine Physician
- Columbia, SC
- NPI 1639590680
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Bedford, IN
- NPI 1548260284
-
- General Acute Care Hospital
- Bloomington, IN
- NPI 1205860335
-
- General Acute Care Hospital
- Indianapolis, IN
- NPI 1144266024
-
- Critical Access Hospital
- Paoli, IN
- NPI 1912984451
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663718400000",
"number": "1487145298",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 N SHADELAND AVE",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462194959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2651 E DISCOVERY PKWY",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474089059",
"telephone_number": "812-353-9515"
}
],
"practiceLocations": [
{
"address_1": "14 Richland Medical Park Dr Ste 350",
"address_purpose": "LOCATION",
"city": "Columbia",
"state": "SC",
"postal_code": "292036896",
"country_code": "US",
"telephone_number": "803-434-7088",
"fax_number": "803-434-3946",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VANDEKOPPEL",
"first_name": "PAUL",
"middle_name": "JOSEPH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-05-29",
"last_updated": "2022-09-21",
"certification_date": "2022-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "SC",
"license": "52464",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IN",
"license": "01088496A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "524640",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; 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.