Mark David Vanderbilt, M.D.

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

License

MD 046732 L Issued in PA

Practice address

4800 Friendship Ave
Pittsburgh, PA 15224-1722

Phone

(412) 359-6656

Fax

(412) 359-6653

NPI assigned

Apr 20, 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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446681600000",
    "number": "1831154764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 FRIENDSHIP AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152241722",
            "telephone_number": "412-359-6656",
            "fax_number": "412-359-6653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 FRIENDSHIP AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152241722",
            "telephone_number": "412-359-6656",
            "fax_number": "412-359-6653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERBILT",
        "first_name": "MARK",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2015-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "PA",
            "license": "MD 046732 L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012839580001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "217529000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2199857",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marta B Vance, BSW
• Susan Nickel Vancleve, CRNP, CPNP
• Nkokota Vanda, B.S.
• Jack E Vande Visse Jr., DMD
• Rachel Vanderberg
• Beverly June Vanderhorst
• Kathleen Vanderkolk
• Benjamin Vanderschelden, MD
• Donna Vanderveen
• Royce J. Vandervort, CRNA

• Critical Care Medicine (Internal Medicine) Physician in Pittsburgh, PA
• Providers in Pittsburgh, PA by specialty
• Critical Care Medicine (Internal Medicine) Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2015; 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.