Mary Van Kooten, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01057928A Issued in IN

Practice address

550 S Landmark Ave
Bloomington, IN 47403-3239

Phone

(812) 355-6900

Fax

(812) 333-5978

NPI assigned

Jun 16, 2005

Sex

Female

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 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Family Practice

Education

Indiana University School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Indiana University Health Southern Indiana Physicians LLCGroup PAC ID 6204748197, 474 clinicians

Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Indiana University Health Bloomington Hospital Hospital, Bloomington, IN, CCN 150051
• Indiana University Health Hospital, Indianapolis, IN, CCN 150056

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mvankooten@direct.iuhealth.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.

• Iu Health Medical Group, LLC

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1326893777
  Medicare reassignment Care Compare group NPD
• Indiana University Health Southern Indiana Physicians, LLC

  • Multi-Specialty Clinic/Center
  • Bloomington, IN
  • NPI 1013953983
  Medicare reassignment Care Compare group
• Anesthesia Care of Bloomington PC

  • Anesthesiology Physician
  • Bloomington, IN
  • NPI 1093990541
  NPD (past)
• Ima Inc Laboratory

  • Clinical Medical Laboratory
  • Bloomington, IN
  • NPI 1588669667
  NPD (past)
• Ima, Inc.

  • Internal Medicine Physician
  • Bloomington, IN
  • NPI 1710974266

  Family Medicine

  NPD (past)
• Ima, Inc. Physical Therapy

  • Physical Therapy Clinic/Center
  • Bloomington, IN
  • NPI 1750564274
  NPD (past)
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)
• Monroe Physicians Group

  • General Acute Care Hospital
  • Bloomington, IN
  • NPI 1588863534
  NPD (past)
• Premier Healthcare LLC

  • Internal Medicine Physician
  • Bloomington, IN
  • NPI 1548580764

  Family Medicine

  NPD (past)

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

• Indiana University Health Bloomington Inc

  • General Acute Care Hospital
  • Bloomington, IN
  • NPI 1205860335
  Care Compare affiliation
• Indiana University Health Inc

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1144266024
  Care Compare affiliation

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694217600000",
    "number": "1619972601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S LANDMARK AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474033239",
            "telephone_number": "812-355-6900",
            "fax_number": "812-333-5978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN KOOTEN",
        "first_name": "MARY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2023-09-09",
        "certification_date": "2023-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "IN",
            "license": "01057928A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01057928A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "090540396",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD PTAN",
            "identifier": "Q00228730",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200452880",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mvankooten@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "550 S Landmark Ave",
            "city": "Bloomington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474033239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Erika Vallandingham, SLP
• Van Buren Township Fire Department
• Anthony Willem Van de Venter
• Alison Van Doren, PT, DPT
• Alyssa Rose Van Duzer, PA-C
• Karen Vanarsdale, LCSW
• Paul Joseph Vandekoppel, MD
• Madeleine Jane Vandenbrink, MD
• Larry Wayne Vandermolen, PA-C
• David Vandeventer, BCBA

• Family Medicine Physician in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2023; 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.