Individual provider Active NPI

John K Hamelink, MD

  • Vascular Surgery Physician
  • Bloomington, IN
National Provider Identifier
1497752323
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
01052762A Issued in IN
Practice address
550 S Landmark Ave
Bloomington, IN 47403-3239
Phone
(812) 339-1100
Fax
(812) 339-1292
NPI assigned
Jul 7, 2005
Last updated
Dec 15, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 01052762A IN Primary

Addresses

Primary practice location

550 S Landmark Ave
Bloomington, IN 47403-3239

Mailing address

550 S Landmark Ave
Bloomington, IN 47403-3239
Phone (812) 339-1100

Other identifiers 3

IdentifierTypeStateIssuer
64026446MedicaidKY
386607090MedicaidIL
200285190AMedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jhamelink@direct.iuhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20051121000086 IN Practitioner - Vascular Surgery 8224057146 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Peripheral Vascular Care Vascular Surgery CurrentSince Sep 1, 2007 Accepting new patients
Ohio Valley Heartcare Inc Past Accepting new patients
Ohio Valley Heartcare Inc Past Accepting new patients
Vascular Surgery & Technology Vascular Surgery Past Accepting new patients

Locations

640 S Walker St
Bloomington, IN 47403
Phone (812) 336-4947

654 S Walker St
Bloomington, IN 47403
Phone (812) 339-6456

Interoperability endpoints

  • Direct secure messaging: jhamelink@direct.iuhealth.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.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1497752323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 S LANDMARK AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474033239",
            "telephone_number": "812-339-1100",
            "fax_number": "812-339-1292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S LANDMARK AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474033239",
            "telephone_number": "812-339-1100",
            "fax_number": "812-339-1292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMELINK",
        "first_name": "JOHN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IN",
            "license": "01052762A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64026446",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "386607090",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200285190A",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jhamelink@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "550 S Landmark Ave",
            "city": "Bloomington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474033239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.