Individual provider Active NPI

Kristen C Vandervelde, D.O.

  • Emergency Medicine Physician
  • Orlando, FL
National Provider Identifier
1487992343
Registry record updated Jan 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS12002 Issued in FL
Practice address
7727 Lake Underhill Rd
Orlando, FL 32822-8224
Phone
(407) 303-6413
NPI assigned
Jan 27, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OS12002 FL Primary

Addresses

Primary practice location

7727 Lake Underhill Rd
Orlando, FL 32822-8224

Mailing address

12957 Mallory Cir Apt 205
Orlando, FL 32828-3806
Phone (727) 674-8641

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20140729000338 FL Practitioner - Emergency Medicine 2769608769 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Emergency Physicians Kang and Associates MD LLCGroup PAC ID 0143113878, 318 clinicians

Practice addresses (Care Compare)

1909 E Hwy 50
Clermont, FL 34711-1921
Phone (352) 717-3800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS12002FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Emergency Physicians Kang and Associates MD LLC Emergency Medicine CurrentSince Jul 1, 2014 Accepting new patients

Locations

1909 E Highway 50
Clermont, FL 34711
Phone (352) 717-3800

7727 Lk Under Hl
Orlando, FL 32822
Phone (407) 303-6413

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

Organizations & group practices 1

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.

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": "1359244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359244800000",
    "number": "1487992343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12957 MALLORY CIR APT 205",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328283806",
            "telephone_number": "727-674-8641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7727 LAKE UNDERHILL RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328228224",
            "telephone_number": "407-303-6413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERVELDE",
        "first_name": "KRISTEN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-27",
        "last_updated": "2013-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS12002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.