Susan J Vandellen, D.O.

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

5101009277 Issued in MI

Practice address

940 River Centre Dr
Port Huron, MI 48060-4463

Phone

(810) 985-4900

Fax

(810) 985-3634

NPI assigned

Aug 11, 2005

Last updated

Dec 4, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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 MI

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

Specialty

Rheumatology

Education

At Still University of Health Sciences, College of Osteo Med, Kirksville, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Henry Ford Health St. John HospitalGroup PAC ID 3173424082, 332 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165
• Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053
• McLaren Port Huron Hospital, Port Huron, MI, CCN 230216
• Henry Ford Macomb Hospital Hospital, Clinton Township, MI, CCN 230047

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AIIFDD
• Direct secure messaging: svandellen384030@direct.hfhs.org

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.

• Henry Ford Health St. John Hospital

  dba St John North Shores Hospital

  • Podiatrist
  • Harrison Township, MI
  • NPI 1043478910
  Medicare reassignment Care Compare group NPD
• Henry Ford Health St. John Hospital

  dba Henry Ford St John Hospital

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1912965088

  Rheumatology

  NPD
• Henry Ford Health St. John Hospital

  dba St John Hospital and Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1023088168
  NPD
• Orthopedic Associates of Port Huron PC

  • Durable Medical Equipment & Medical Supplies
  • Port Huron, MI
  • NPI 1013068188
  NPD (past)
• Shores Rheumatology PC

  • Rheumatology Physician
  • Saint Clair Shores, MI
  • NPI 1497975510
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Henry Ford Health System

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1134144801
  Care Compare affiliation
• Henry Ford Macomb Hospital Corporation

  dba Henry Ford Health Macomb Hospital

  • General Acute Care Hospital
  • Clinton TWP, MI
  • NPI 1023114634
  Care Compare affiliation
• Henry Ford Macomb Hospital Corporation

  • General Acute Care Hospital
  • Warren, MI
  • NPI 1902842735
  Care Compare affiliation
• McLaren Port Huron

  • General Acute Care Hospital
  • Port Huron, MI
  • NPI 1982685384
  Care Compare affiliation
• Henry Ford Health St. John Hospital

  dba St John Hospital and Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1023088168
  Care Compare affiliation

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259884800000",
    "number": "1598767394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 RIVER CENTRE DR",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480604463",
            "telephone_number": "810-985-4900",
            "fax_number": "810-985-3634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 RIVER CENTRE DR",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480604463",
            "telephone_number": "810-985-4900",
            "fax_number": "810-985-3634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDELLEN",
        "first_name": "SUSAN",
        "middle_name": "J",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-11",
        "last_updated": "2009-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MI",
            "license": "5101009277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arunas S Vaitiekaitis, DDS
• Krishna D Valjee, MD
• Permporn Vanasupa, MD
• Lawrence K Vanbelle, RPH
• Rosemary Jean Vanbuskirk
• Kacey Ann Vanderpool, LLBSW
• Taylor Ann Vandusen
• Danielle Louise Vanhevel, DNAP, CRNA
• Timothy R Vanhowe, C.R.N.A.
• Shaylyn Vanmilligan

• Rheumatology Physician in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Rheumatology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.