Theodore J. Vanderkooi, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

065627 Issued in MI

Practice address

1316 Mercy Dr
Muskegon, MI 49444-1835

Phone

(231) 739-9461

Fax

(231) 739-1984

NPI assigned

May 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

General Surgery

Education

University of Michigan Medical School, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Muskegon Surgical Associates PCGroup PAC ID 0941262877, 27 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health Muskegon Hospital Hospital, Muskegon, MI, CCN 230066

Procedures performed for Medicare patients

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.

• Muskegon Surgical Associates PC

  • Surgery Physician
  • Muskegon, MI
  • NPI 1225101660
  Medicare reassignment Care Compare group NPD
• Muskegon Surgical Associates Surgicenter, PLC

  • Ambulatory Surgical Clinic/Center
  • Muskegon, MI
  • NPI 1184485146

  Surgery

  Medicare reassignment NPD
• Christian Healthcare Specialists, Inc.

  • Obstetrics & Gynecology Physician
  • Grand Rapids, MI
  • NPI 1184242760
  NPD (past)
• Mercy Health Partners

  • General Acute Care Hospital
  • Muskegon, MI
  • NPI 1831132133
  NPD (past)
• Pine Medical Group PC

  • Family Medicine Physician
  • Fremont, MI
  • NPI 1093980187

  Surgery

  NPD (past)

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

• Mercy Health Partners

  • General Acute Care Hospital
  • Muskegon, MI
  • NPI 1831132133
  Care Compare affiliation

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1801849120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 MERCY DR",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441835",
            "telephone_number": "231-739-9461",
            "fax_number": "231-739-1981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1316 MERCY DR",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441835",
            "telephone_number": "231-739-9461",
            "fax_number": "231-739-1984"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "230 W Oak St",
            "address_2": "Suite 201",
            "address_purpose": "LOCATION",
            "city": "Fremont",
            "state": "MI",
            "postal_code": "494121575",
            "country_code": "US",
            "telephone_number": "231-924-4200",
            "fax_number": "616-267-9046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDERKOOI",
        "first_name": "THEODORE",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "065627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eleysia Jade Vandenbosch
• Nicholas Alan Vandenbosch, D.O.
• Rebecca A Vandenbroek, PA
• Bradley Allen Vanderhulst, LPN
• Darlene June Vanderkolk, LMSW
• Vickie L Vanderlaan
• Robert Vandermeer, OTR
• Julie Ann Vandermeulen, MSW
• Glen Vanderschaaf, NP
• Trent Joseph Vanderstelt, CPED

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; 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.