Active NPI
Marjan Vandevar, D.O.
- Nephrology Physician
- Ft Lauderdale, FL
National Provider Identifier
1861759862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- OS12532
- Practice address
- 315 SE 13TH St
Ft Lauderdale, FL 33316-1923 - Phone
- (954) 767-5900
- NPI assigned
- Apr 13, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 | UO2056 | FL | |
| Nephrology Physician | 207RN0300X | OS12532 | FL | Primary |
Addresses
Primary practice location
315 SE 13TH St
Ft Lauderdale, FL 33316-1923
Mailing address
315 SE 13TH St
Fort Lauderdale, FL 33316-1923
Phone (305) 479-4638
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010750300 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Osteopathic Manipulative Medicine
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
301 S W Crown Point Rd
Suite 120
Winter Garden, FL 34787-2950
Phone (407) 297-8408
Hospital & facility affiliations
- West Orange Winter Garden Dialysis Center LLC
- Bma - West Orlando
- Adventhealth Orlando
- Orlando Health-Health Central Hospital
- Orlando Health
Merit-based Incentive Payment System (MIPS)
- Final score
- 98.49 of 100
- Quality
- 89.92
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 72.94
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| UO2056 | FL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Orange Wellness LLC | Current | Accepting new patients | |
| West Orange Nephrology LLC | Nephrology | Current | Accepting new patients |
| Onyx Medical & Wellness Center LLC | Nephrology | Current | Accepting new patients |
Locations
10000 W Colonial Dr
Ste 180
Ocoee, FL 34761
Phone (407) 578-6610
1743 Park Center Dr
Ste 350
Orlando, FL 32835
Phone (321) 329-5950
301 S West Crown Point Rd
Ste 120
Winter Garden, FL 34787
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/BCFJCA
Organizations & group practices 3
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.
-
- Nephrology Physician
- Winter Garden, FL
- NPI 1578534749
-
- Infusion Therapy Clinic/Center
- Orlando, FL
- NPI 1952118242
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Winter Garden, FL
- NPI 1174902779
Dialysis facility
-
- General Acute Care Hospital
- Orlando, FL
- NPI 1306938071
-
- Clinical Medical Laboratory
- Orlando, FL
- NPI 1801569728
Hospital
-
- General Acute Care Hospital
- Ocoee, FL
- NPI 1033475959
-
- General Acute Care Hospital
- Orlando, FL
- NPI 1184709057
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624752000000",
"number": "1861759862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "315 SE 13TH ST",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333161923",
"telephone_number": "305-479-4638"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 SE 13TH ST",
"city": "FT LAUDERDALE",
"state": "FL",
"postal_code": "333161923",
"telephone_number": "954-767-5900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDEVAR",
"first_name": "MARJAN",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-04-13",
"last_updated": "2021-06-27",
"certification_date": "2021-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "UO2056",
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "FL",
"license": "OS12532",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010750300",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ft Lauderdale, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2021; 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.