NPIMap

Individual provider Active NPI

Patricia Gail Vandiepen, DO

  • Internal Medicine Physician
  • Ormond Beach, FL
National Provider Identifier
1568435659
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS7544 Issued in FL
Practice address
279 S Yonge St
Ormond Beach, FL 32174-6257
Phone
(386) 673-2133
Fax
(386) 673-2743
NPI assigned
Feb 9, 2006
Sex
Female
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
Internal Medicine Physician 207R00000X OS7544 FL Primary

Addresses

Primary practice location

279 S Yonge St
Ormond Beach, FL 32174-6257

Mailing address

279 S Yonge St
Ormond Beach, FL 32174-6257
Phone (386) 673-2133

Other identifiers 3

IdentifierTypeStateIssuer
57583OtherFLBCBS NUMBER
567660OtherFLAETNA NUMBER
P00096989OtherFLRRMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031215000032 FL Practitioner - Internal Medicine 7315844818 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Oklahoma State University College of Osteopathic Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ormond Internal Medicine LLCGroup PAC ID 8123192275, 2 clinicians

Practice addresses (Care Compare)

279 S Yonge St
Ormond Beach, FL 32174-6257

Hospital & facility affiliations

  • Trilogy Home Healthcare Home health agency, Jacksonville, FL, CCN 107689
  • Adventhealth Home Health Home health agency, Ormond Beach, FL, CCN 107408
  • Centerwell Home Health Home health agency, Daytona Beach, FL, CCN 107338
  • Halifax Health Care at Home Home health agency, Port Orange, FL, CCN 108359
  • Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068
  • Halifax Health Medical Center Hospital, Daytona Beach, FL, CCN 100017
  • AdventHealth Palm Coast Hospital, Palm Coast, FL, CCN 100118

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS7544FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ormond Internal Medicine LLC Internal Medicine CurrentSince Jul 1, 1999 Accepting new patients

Locations

279 S Yonge St
Ormond Beach, FL 32174
Phone (386) 673-2133

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11843/brand/1/csg/1/fhir/r4
  • Direct secure messaging: patricia.van.diepen.1@11843.direct.athenahealth.com

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 8

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": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568435659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 S YONGE ST",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321746257",
            "telephone_number": "386-673-2133",
            "fax_number": "386-673-2743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 S YONGE ST",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321746257",
            "telephone_number": "386-673-2133",
            "fax_number": "386-673-2743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDIEPEN",
        "first_name": "PATRICIA",
        "middle_name": "GAIL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS7544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NUMBER",
            "identifier": "57583",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA NUMBER",
            "identifier": "567660",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMEDICARE",
            "identifier": "P00096989",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

Verify at the official NPI Registry.