Michael Henry Vanderlick, MD

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

MD.14489R Issued in LA

Practice address

4801 Ambassador Caffery Pkwy
Lafayette, LA 70508

Phone

(337) 470-2605

Fax

(337) 470-4595

NPI assigned

Jun 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in LA

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

Internal Medicine

Education

Louisiana State University School of Medicine in Shreveport, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lourdes Physician Group LLCGroup PAC ID 7214177757, 157 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Our Lady of Lourdes Regional Medical Center, Inc Hospital, Lafayette, LA, CCN 190102
• Iberia Medical Center Hospital, New Iberia, LA, CCN 190054
• Ochsner Lafayette General Medical Center Hospital, Lafayette, LA, CCN 190002
• Abbeville General Hospital Hospital, Abbeville, LA, CCN 190034

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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 and National Provider Directory roles.

• Lourdes Physician Group LLC

  • Family Medicine Physician
  • Lafayette, LA
  • NPI 1437405883
  Medicare reassignment Care Compare group NPD
• Jaime M. Cordova, M.D., Apmc

  • Primary Care Clinic/Center
  • Breaux Bridge, LA
  • NPI 1447554365
  NPD
• Our Lady of Lourdes Regional Medical Center

  • Emergency Medicine Physician
  • Lafayette, LA
  • NPI 1538181128
  NPD (past)
• Our Lady of Lourdes Regional Medical Center, Inc

  • General Acute Care Hospital
  • Lafayette, LA
  • NPI 1598766495
  NPD (past)

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

• Abbeville General Hospital

  • Rural Acute Care Hospital
  • Abbeville, LA
  • NPI 1255300414
  Care Compare affiliation
• Hospital Service District No 1 of Iberia Parish

  • Rehabilitation Hospital Unit
  • New Iberia, LA
  • NPI 1992159925
  Care Compare affiliation
• Hospital Service District No. 1 of Iberia Parish

  • General Acute Care Hospital
  • New Iberia, LA
  • NPI 1285601088
  Care Compare affiliation
• Lafayette General Medical Center Inc

  • General Acute Care Hospital
  • Lafayette, LA
  • NPI 1275536799
  Care Compare affiliation
• Our Lady of Lourdes Regional Medical Center, Inc

  • General Acute Care Hospital
  • Lafayette, LA
  • NPI 1598766495
  Care Compare affiliation

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1598791691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "225-526-0011",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 AMBASSADOR CAFFERY PKWY",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "70508",
            "telephone_number": "337-470-2605",
            "fax_number": "337-470-4595"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 W Saint Mary Blvd",
            "address_2": "STE 210",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "LA",
            "postal_code": "705063568",
            "country_code": "US",
            "telephone_number": "337-291-1162 x5",
            "fax_number": "337-264-1499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDERLICK",
        "first_name": "MICHAEL",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "14489R",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "LA",
            "license": "MD.14489R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1120561",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mvanderlick7360@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mvanderlick7360@direct.casso.us.com",
            "address_1": "4801 Ambassador Caffery Pkwy",
            "city": "Lafayette",
            "state": "LA",
            "country_code": "US",
            "postal_code": "70508",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4801 Ambassador Caffery Pkwy",
            "city": "Lafayette",
            "state": "LA",
            "country_code": "US",
            "postal_code": "70508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Carolyn Van
• Rebecca Vance
• Florence Vanderborght
• Keia Vanderburg
• Cecilia Vanderlick Roberson, FNP, PMHNP
• Jamie Ruth Vanhuis, APRN, FNP-C
• Yogeeta Varadarajalu Naidu, MD
• Tyler James Varisco
• Victor Joseph Varisco, OT
• Bailie Marsh Varn, PT

• Hospitalist Physician in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Hospitalist Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; 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.