Laurie Marie Van Donselaar, DO

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

02004178A Issued in IN

Practice address

6911 E US Highway 36
Avon, IN 46123-8926

Phone

(317) 272-8033

Fax

(317) 272-8044

NPI assigned

Apr 14, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Laurie Marie Krusko Former name

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

Obstetrics/Gynecology

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hendricks County HospitalGroup PAC ID 4880505528, 341 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hendricks Regional Health Hospital, Danville, IN, CCN 150005

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://sehproxy.stelizabeth.com/arr-fhir/api/FHIR/R4
• Direct secure messaging: lvan228429@direct-prd.stelizabeth.com

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.

• Hendricks County Hospital

  • General Practice Physician
  • Danville, IN
  • NPI 1497536163
  Medicare reassignment Care Compare group NPD
• Hendricks County Hospital

  • Pediatrics Physician
  • Brownsburg, IN
  • NPI 1508758210
  NPD
• Hendricks County Hospital

  • Obstetrics & Gynecology Physician
  • Avon, IN
  • NPI 1912008343
  NPD
• Hendricks County Hospital

  • Urgent Care Clinic/Center
  • Avon, IN
  • NPI 1063411551
  NPD (past)
• Hendricks County Hospital

  • Family Medicine Physician
  • Plainfield, IN
  • NPI 1104927557
  NPD (past)
• Hendricks County Hospital

  • Family Medicine Physician
  • Avon, IN
  • NPI 1598993784
  NPD (past)

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

• Hendricks County Hospital

  • General Acute Care Hospital
  • Danville, IN
  • NPI 1669475950
  Care Compare affiliation

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

{
    "created_epoch": "1239667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1639312168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 SOUTHFIELD DR STE 1370",
            "city": "PLAINFIELD",
            "state": "IN",
            "postal_code": "461684300",
            "telephone_number": "317-837-5566",
            "fax_number": "317-837-5580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6911 E US HIGHWAY 36",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461238926",
            "telephone_number": "317-272-8033",
            "fax_number": "317-272-8044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DONSELAAR",
        "first_name": "LAURIE",
        "middle_name": "MARIE",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-14",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IN",
            "license": "02004178A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201096470",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lvan228429@direct-PRD.stelizabeth.com",
            "affiliation": "N",
            "address_1": "6911 E US Highway 36",
            "city": "Avon",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461238926",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LAURIE",
            "last_name": "KRUSKO",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Michelle F Vallejos
• Emileah Van Matre, D.C.
• Rebecca Vandenburgh, LCSW
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• Tamara Maxine Vanwinkle, MSW, LCSW
• Moriah Veach

• Obstetrics & Gynecology Physician in Avon, IN
• Providers in Avon, IN by specialty
• Obstetrics & Gynecology Physician in Indiana

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