Individual provider Active NPI

James P Vangelder, M.D.

  • Nephrology Physician
  • Hollywood, FL
National Provider Identifier
1720075658
Registry record updated Dec 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME22201 Issued in FL
Practice address
3700 Washington St
Suite 500
Hollywood, FL 33021-8259
Phone
(954) 962-0338
Fax
(954) 962-2357
NPI assigned
Oct 5, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X ME22201 FL Primary

Addresses

Primary practice location

3700 Washington St
Suite 500
Hollywood, FL 33021-8259

Mailing address

3700 Washington St
Suite 500
Hollywood, FL 33021-8259
Phone (954) 962-0338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
22201FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hollywood Artificial Kidney Center LTD PastSince Jul 10, 1995 Accepting new patients
Pembroke Pines Artificial Kidney Center Inc PastSince Nov 20, 1989 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: martin.mapanao@direct.tmcmed.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260489600000",
    "number": "1720075658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 WASHINGTON ST",
            "address_2": "SUITE 500",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330218259",
            "telephone_number": "954-962-0338",
            "fax_number": "954-962-2357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 WASHINGTON ST",
            "address_2": "SUITE 500",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330218259",
            "telephone_number": "954-962-0338",
            "fax_number": "954-962-2357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANGELDER",
        "first_name": "JAMES",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2009-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME22201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.