Individual provider Active NPI

Scott Russell Vanden Bosch, PA-C

  • Physician Assistant
  • Coldwater, MI
National Provider Identifier
1891152146
Registry record updated Jan 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
121 Hatch Ave
Coldwater, MI 49036-1242
Phone
(616) 644-4821
NPI assigned
Jan 18, 2016
Last updated
Jan 18, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

121 Hatch Ave
Coldwater, MI 49036-1242

Mailing address

121 Hatch Ave
Coldwater, MI 49036-1242
Phone (616) 644-4821

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, IN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160314000921 MI Practitioner - Physician Assistant 0345546651 Reassigns benefits to 2 organizations
I20210707000909 IN Practitioner - Physician Assistant 0345546651 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

168 S Howell St
Hillsdale, MI 49242-2040
Phone (517) 437-4451

410 N Willowbrook Rd
Coldwater, MI 49036-9462
Phone (517) 279-9599

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.57 of 100Reported as group
Quality
100
Improvement activities
40
Cost
85.25

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Practice & Orthopedic Care Center P.C. CurrentSince Jan 23, 2017 Accepting new patients
Advanced Veins and Vascular Management PLC Past Accepting new patients

Locations

416 E Maumee St
Angola, IN 46703
Phone (260) 665-2141

410 N Willowbrook Rd
Coldwater, MI 49036
Phone (517) 279-7887

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EIBIBD

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1453075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453075200000",
    "number": "1891152146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 HATCH AVE",
            "city": "COLDWATER",
            "state": "MI",
            "postal_code": "490361242",
            "telephone_number": "616-644-4821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 HATCH AVE",
            "city": "COLDWATER",
            "state": "MI",
            "postal_code": "490361242",
            "telephone_number": "616-644-4821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDEN BOSCH",
        "first_name": "SCOTT",
        "middle_name": "RUSSELL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-18",
        "last_updated": "2016-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coldwater, MI

Sources for this page

Verify at the official NPI Registry.