Individual provider Active NPI

Leonard Henry Vangelder, PT, DPT

  • Physical Therapist
  • Grand Rapids, MI
National Provider Identifier
1831526383
Registry record updated Jun 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501016469 Issued in MI
Practice address
5429 Northland Dr NE Ste a
Grand Rapids, MI 49525-1089
Phone
(616) 855-0540
Fax
(616) 855-1185
NPI assigned
Sep 30, 2013
Last updated
Jun 7, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501016469 MI Primary

Addresses

Primary practice location

5429 Northland Dr NE Ste a
Grand Rapids, MI 49525-1089

Mailing address

5429 Northland Dr NE Ste a
Grand Rapids, MI 49525-1089
Phone (616) 855-0540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140113000242 MI Practitioner - Physical Therapist in Private Practice 8325276686 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

5429 Northland Dr NE
Suite a
Grand Rapids, MI 49525-1089
Phone (616) 855-0540

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501016469MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Institute of Contextual Human Health, Wellness, and Performance Physical Therapist CurrentSince Oct 1, 2024 Accepting new patients
Dynamic Movement and Recovery Physical Therapist CurrentSince Sep 10, 2018 Accepting new patients

Locations

4950 Plainfield Ave NE
Ste A
Grand Rapids, MI 49525
Phone (616) 855-0540

5429 Northland Dr NE
Ste A
Grand Rapids, MI 49525
Phone (616) 855-0540

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": "1380499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1831526383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5429 NORTHLAND DR NE STE A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495251089",
            "telephone_number": "616-855-0540",
            "fax_number": "616-855-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5429 NORTHLAND DR NE STE A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495251089",
            "telephone_number": "616-855-0540",
            "fax_number": "616-855-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANGELDER",
        "first_name": "LEONARD",
        "middle_name": "HENRY",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-30",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501016469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.