Individual provider Active NPI

Ronald Vandyke, CRNA

  • Certified Registered Nurse Anesthetist
  • Kalamazoo, MI
National Provider Identifier
1528034287
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704216267 Issued in MI
Practice address
900 Peeler St
Kalamazoo, MI 49008-2380
Phone
(269) 345-8618
Fax
(269) 345-1508
NPI assigned
Feb 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 4704216267 MI Primary

Addresses

Primary practice location

900 Peeler St
Kalamazoo, MI 49008-2380

Mailing address

900 Peeler St
Kalamazoo, MI 49008-2380
Phone (269) 345-8618

Other identifiers 1

IdentifierTypeStateIssuer
4843073MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060425000329 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 8628088473 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
Medicare assignment
May accept Medicare assignment
Group practices
Apollo Medical Group of Michigan PLLCGroup PAC ID 6103354329, 24 clinicians
Rest Assured Anesthesia Management IncGroup PAC ID 3274971007, 21 clinicians

Practice addresses (Care Compare)

31 N Saint Joseph Ave
Niles, MI 49120-2207
Phone (269) 683-5510

3200 W Centre Ave
Suite 101
Portage, MI 49024-4889
Phone (269) 323-9950

3600 Capital Ave SW
Suite 101
Battle Creek, MI 49015-9393
Phone (269) 979-2490

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704216267MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Hospitals at Niles and St Joseph, Inc Current Accepting new patients
Lakeland Hospitals at Niles and St Joseph, Inc CurrentSince Jul 23, 2022 Accepting new patients
McLaren Central Michigan Nurse Anesthetist, Certified Registered CurrentSince Jan 9, 2023 Accepting new patients
Apollo Medical Group of Michigan PLLC Nurse Anesthetist, Certified Registered CurrentSince Feb 17, 2026 Accepting new patients
Covenant Medical Center, Inc CurrentSince Oct 24, 2022 Accepting new patients
Covenant Medical Center, Inc. Nurse Anesthetist, Certified Registered CurrentSince Oct 24, 2022 Accepting new patients
McLaren Hospital Group CurrentSince Jan 1, 2026 Accepting new patients
Rest Assured Anesthesia Management, Inc. Nurse Anesthetist, Certified Registered CurrentSince Jun 22, 2024 Accepting new patients
Lakeland Hospitals at Niles and St Joseph, Inc Nurse Anesthetist, Certified Registered CurrentSince Jul 23, 2022 Accepting new patients
McLaren Central Michigan Current Accepting new patients
McLaren Central Michigan CurrentSince Jan 9, 2023 Accepting new patients
McLaren Central Michigan Current Accepting new patients

Locations

3600 Capital Ave SW
Ste 101
Battle Creek, MI 49015
Phone (269) 979-2490

401 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000

1221 South Dr
Mt Pleasant, MI 48858
Phone (989) 772-6700

31 N Saint Joseph Ave
Niles, MI 49120
Phone (269) 428-2417

3200 W Centre Ave
Ste 101
Portage, MI 49024
Phone (269) 323-9905

1447 N Harrison St
Saginaw, MI 48602
Phone (989) 583-4220

700 Cooper Ave
Saginaw, MI 48602
Phone (989) 583-6000

1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941

Organizations & group practices 12

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 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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1528034287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 PEELER ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490082380",
            "telephone_number": "269-345-8618",
            "fax_number": "269-345-1508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 PEELER ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490082380",
            "telephone_number": "269-345-8618",
            "fax_number": "269-345-1508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDYKE",
        "first_name": "RONALD",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704216267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4843073",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.