Jeremy Jensen Vanduluitgaarden

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

047585 Issued in NY

Practice address

6000 Brockton Dr
Lockport, NY 14094-9273

Phone

(716) 282-2888

NPI assigned

Oct 30, 2021

Last updated

Oct 30, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, MD2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Maryland Orthopaedic Associates PAGroup PAC ID 0042108722, 68 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

99

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• University of Maryland Orthopaedic Associates P a

  • Pediatric Orthopaedic Surgery Physician
  • Baltimore, MD
  • NPI 1740235274

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Advanced Care Physical Therapy Aquatics and Fitness PC

  • Physical Therapist
  • Niagara Falls, NY
  • NPI 1891883385

  Single Specialty

  Medicare reassignment NPD
• University of Maryland Medical Regional Professional Services, LLC

  dba Towson Sports Medicine

  • Physical Therapist
  • Towson, MD
  • NPI 1225383250

  Single Specialty

  Medicare reassignment NPD
• University of Maryland Medical Regional Professional Services, LLC

  dba Towson Sports Medicine

  • Durable Medical Equipment & Medical Supplies
  • Rosedale, MD
  • NPI 1447003025

  Orthopedic

  NPD
• University of Maryland Orthopaedic Associates PA

  • Orthopaedic Surgery Physician
  • Laurel, MD
  • NPI 1649080714
  NPD
• Rose Physical Therapy PLLC

  • Orthopedic Physical Therapist
  • Williamsville, NY
  • NPI 1306151550

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1635552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635552000000",
    "number": "1548924061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4503 STONEY BROOK RD",
            "city": "ONEIDA",
            "state": "NY",
            "postal_code": "134213715",
            "telephone_number": "315-762-3533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 BROCKTON DR",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140949273",
            "telephone_number": "716-282-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDULUITGAARDEN",
        "first_name": "JEREMY",
        "middle_name": "JENSEN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-30",
        "last_updated": "2021-10-30",
        "certification_date": "2021-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NY",
            "license": "047585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victor Ryan Ubiles, DPT
• Amanda Ann Ulsifer, PMHNP
• Jessica A Vaeth, MSPT
• Jenna Christine Van Dusen, DO
• Alicia Vanderwalker, FPA-C
• Connor Vanko, PA
• Mark Varallo, MD
• Nicholas Varallo, MD
• Vigel Varkey, M.D.
• Village Pharmacy of Lockport, Inc.

• Orthopedic Physical Therapist in Lockport, NY
• Providers in Lockport, NY by specialty
• Orthopedic Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2021; 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.