Active NPI
Russell Aaron Van Maele, DO
- Internal Medicine Physician
- Lexington, KY
National Provider Identifier
1821527292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 04823
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170621001598 | MI | Order and Referring Only - Internal Medicine | 3274801931 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04823 | KY | MD | Internal Medicine Physician |
| 5151012371 | MI | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Van Maele Medical PC | Internal Medicine | Past | Accepting new patients |
| Major Hospital | Past | Accepting new patients |
Interoperability endpoints
- russell.vanmaele@337577483108356.direct.elationemr.com
- 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.
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- NPI 1174555692
-
- Internal Medicine Physician
- Santa Monica, CA
- NPI 1285498485
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.