Individual provider Active NPI

Russell Aaron Van Maele, DO

  • Internal Medicine Physician
  • Lexington, KY
National Provider Identifier
1821527292
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
04823 Issued in KY
Practice address
535 Wellington Way Ste 330
Lexington, KY 40503-1331
Phone
(859) 523-4375
NPI assigned
Jun 8, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 04823 KY Primary
Student in an Organized Health Care Education/Training Program 390200000X 5151012371 MI

Addresses

Primary practice location

535 Wellington Way Ste 330
Lexington, KY 40503-1331

Mailing address

535 Wellington Way Ste 330
Lexington, KY 40503-1331
Phone (859) 523-4375

Other practice location 1

1000 Oakland Dr
Kalamazoo, MI 49008-1282
Phone (269) 337-6300

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170621001598 MI Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 3274801931

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04823KYMDInternal Medicine Physician
5151012371MIMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Van Maele Medical PC Internal Medicine Past Accepting new patients
Major Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: russell.vanmaele@337577483108356.direct.elationemr.com
  • Direct secure messaging: russellvanmaele@316444949610500.direct.elationemr.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1821527292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 WELLINGTON WAY STE 330",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405031331",
            "telephone_number": "859-523-4375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 WELLINGTON WAY STE 330",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405031331",
            "telephone_number": "859-523-4375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Oakland Dr",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490081282",
            "country_code": "US",
            "telephone_number": "269-337-6300",
            "fax_number": "269-337-6222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN MAELE",
        "first_name": "RUSSELL",
        "middle_name": "AARON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-08",
        "last_updated": "2022-07-21",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "04823",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "5151012371",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.