Wesley Blake Vanderlan, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

4301086703 Issued in MI

Practice address

2799 W Grand Blvd
Detroit, MI 48202-2608

Phone

(313) 916-2600

NPI assigned

May 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 9

Addresses

Other identifiers 1

Other names 1

• Wesley B. Blake Von Riedenauer Former name

Medicare fee-for-service enrollment

Enrolled in LA, MI, FL, GA, NY, AL7 enrollments

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 7

Specialty

General Surgery

Education

Uniformed Services Uhs Fe Hebert School of Med, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Keystone Medical Services of Alabama, Inc.Group PAC ID 7719365352, 12 clinicians

Paragon Emergency Services LLCGroup PAC ID 8628153087, 401 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Crenshaw Community Hospital Hospital, Luverne, AL, CCN 011308
• Troy Regional Medical Center Hospital, Troy, AL, CCN 010126

Merit-based Incentive Payment System (MIPS)

Final score

83.62 of 100Reported as group

Quality

70.88

Improvement activities

40

Cost

75.82

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 43)

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
• Direct secure messaging: weva2715@yourcarecommunity.org
• Direct secure messaging: wvonriedenauer1074083@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 and National Provider Directory roles.

• Keystone Medical Services of Alabama, Inc.

  • Emergency Medicine Physician
  • Troy, AL
  • NPI 1790432243
  Medicare reassignment Care Compare group NPD
• Paragon Emergency Services LLC

  • Emergency Medicine Physician
  • Winter Haven, FL
  • NPI 1912101650
  Medicare reassignment Care Compare group NPD
• Henry Ford Health System

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1134144801
  Medicare reassignment NPD
• Acs Primary Care Physicians Louisiana PC

  • Emergency Medicine Physician
  • Alexandria, LA
  • NPI 1306889092
  Medicare reassignment NPD
• Calcasieu Cameron Hospital Medicine Group LLC

  • Hospitalist Physician
  • Sulphur, LA
  • NPI 1659764967
  Medicare reassignment NPD
• Concord Medical Group PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1083630610

  LA

  Medicare reassignment NPD
• Concord North Texas, PLLC

  • Emergency Medicine Physician
  • Bonham, TX
  • NPI 1952761173

  LA

  Medicare reassignment NPD
• Derussy Emergency Group, LLC

  • Emergency Medicine Physician
  • Marksville, LA
  • NPI 1306300900
  Medicare reassignment NPD
• Emergency Group of Columbus, LLC

  • Emergency Medicine Physician
  • Columbus, GA
  • NPI 1316458227
  Medicare reassignment NPD
• Emergency Group of St Landry LLC

  • Emergency Medicine Physician
  • Ville Platte, LA
  • NPI 1164491320
  Medicare reassignment NPD
• Emergency Services of Mobile PC

  • Emergency Medicine Physician
  • Mobile, AL
  • NPI 1013269802
  Medicare reassignment NPD
• Florida Hospital Medical Group Inc

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1225034234

  Surgery

  Medicare reassignment NPD

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

• Crenshaw County Health Care Authority

  • Critical Access Hospital
  • Luverne, AL
  • NPI 1750480406
  Care Compare affiliation
• Troy Hospital Health Care Authority

  • Rural Acute Care Hospital
  • Troy, AL
  • NPI 1770814626
  Care Compare affiliation

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1609097898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FORD PL STE 3A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023450",
            "telephone_number": "313-874-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-2600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "999 N Curtis Rd Ste 415",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837061334",
            "country_code": "US",
            "telephone_number": "208-302-2600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2305 37th Ave SW",
            "address_purpose": "LOCATION",
            "city": "Minot",
            "state": "ND",
            "postal_code": "587017669",
            "country_code": "US",
            "telephone_number": "701-418-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3320 Thomasville Rd Ste 302",
            "address_purpose": "LOCATION",
            "city": "Tallahassee",
            "state": "FL",
            "postal_code": "323087971",
            "country_code": "US",
            "telephone_number": "504-391-8320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDERLAN",
        "first_name": "WESLEY",
        "middle_name": "BLAKE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MS",
            "license": "14789",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MS",
            "license": "14789",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ND",
            "license": "20800",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "GA",
            "license": "1930",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "FL",
            "license": "ME115495",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "ID",
            "license": "MC-2691",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "MS",
            "license": "14789",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "MS",
            "license": "14789",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301086703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00117675",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WESLEY B.",
            "last_name": "VON RIEDENAUER",
            "middle_name": "BLAKE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Angel Marie Vance, P.T.A
• Sarah Lynn Vandaele, PA-C
• Dennis Gerard Vandecandelaere, R.PH.
• Dustin Vanderburg
• Amina Vanderhyde, LMSW
• Naomi R. Vandermissen, M.D.
• Anna Vanderschaegen
• Lori Vanderwill
• Matthew Vanderwindt, LCSW
• Victoria Vanderziel-Fultz

• Surgery Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; 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.