Individual provider Active NPI

Craig Vander Kolk, M.D.

  • Plastic Surgery Physician
  • Lutherville, MD
National Provider Identifier
1497782163
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
D35172 Issued in MD
Practice address
10755 Falls Rd
Lutherville, MD 21093-4515
Phone
(410) 955-6897
NPI assigned
Jun 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X D35172 MD Primary

Addresses

Primary practice location

10755 Falls Rd
Lutherville, MD 21093-4515

Mailing address

PO Box 64165
Baltimore, MD 21264-4165

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20070201000527 MD Practitioner - Plastic and Reconstructive Surgery 5597767673 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of Michigan Medical School, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Paul Place Specialists, Inc.Group PAC ID 7719882943, 332 clinicians

Practice addresses (Care Compare)

1734 York Rd
Lutherville, MD 21093-5606
Phone (410) 252-2273

301 Saint Paul St
Baltimore, MD 21202-2102

7602 Belair Rd
Baltimore, MD 21236-4088
Phone (410) 663-8100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.13 of 100Reported as group
Quality
56.5
Promoting interoperability
100
Improvement activities
40
Cost
73.94

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Paul Place Specialists Inc CurrentSince Aug 1, 2006 Accepting new patients
St Paul Place Specialists, Inc. CurrentSince Aug 1, 2006 Accepting new patients
St. Paul Place Specialists, Inc. Current Accepting new patients
Saint Paul Place Specialists, Inc. Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Lutherville Surgery Center, LLC PastSince Apr 17, 2018 Accepting new patients

Locations

7602 Belair Rd
Nottingham, MD 21236
Phone (410) 332-9654

1734 York Rd
Timonium, MD 21093
Phone (410) 252-2273

Interoperability endpoints

  • Direct secure messaging: cvanderkolkmd6107@direct.mdmercy.com

Organizations & group practices 6

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 1

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497782163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64165",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10755 FALLS RD",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210934515",
            "telephone_number": "410-955-6897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDER KOLK",
        "first_name": "CRAIG",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MD",
            "license": "D35172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutherville, MD

Sources for this page

Verify at the official NPI Registry.