Active NPI
Sara Vanbronkhorst, M.D.
- Psychiatry Physician
- Grand Rapids, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 4301507541
- Practice address
- 790 Fuller Ave NE
Grand Rapids, MI 49503-1918 - Phone
- (616) 336-3909
- Fax
- (616) 336-8830
- NPI assigned
- Jul 1, 2015
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 4301108468 | MI | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 293558 | NY | |
| Psychiatry Physician | 2084P0800X | 4301507541 | MI | Primary |
Addresses
Primary practice location
790 Fuller Ave NE
Grand Rapids, MI 49503-1918
Mailing address
790 Fuller Ave NE
Grand Rapids, MI 49503-1918
Phone (616) 336-3909
Other practice location 1
525 E 68th St # 140
New York, NY 10065
Phone (616) 456-0857
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | pcerecords.network180.x@direct.mihin.net | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Michigan State University College of Human Medicine, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
790 Fuller Ave NE
Grand Rapids, MI 49503-1918
Phone (616) 825-5412
Hospital & facility affiliations
- Spectrum Health
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kent County CMH Authority | Current | Accepting new patients | |
| New York University | Current | Accepting new patients | |
| Kent County CMH Authority | Current | Accepting new patients | |
| New York University | Current | Accepting new patients |
Locations
790 Fuller Ave NE
Grand Rapids, MI 49503
Phone (616) 336-3765
14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224
Organizations & group practices 4
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.
-
- Community/Behavioral Health Agency
- Grand Rapids, MI
- NPI 1588935068
-
- Community/Behavioral Health Agency
- Grand Rapids, MI
- NPI 1194617811
-
- Physical Medicine & Rehabilitation Physician
- Boynton Beach, FL
- NPI 1104787613
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Hastings, MI
- NPI 1932695525
-
- General Acute Care Hospital
- Grand Rapids, MI
- NPI 1922090554
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667520000000",
"number": "1912380593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 FULLER AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495031918",
"telephone_number": "616-336-3909",
"fax_number": "616-336-8830"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "790 FULLER AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495031918",
"telephone_number": "616-336-3909",
"fax_number": "616-336-8830"
}
],
"practiceLocations": [
{
"address_1": "525 E 68th St # 140",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "10065",
"country_code": "US",
"telephone_number": "616-456-0857",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VANBRONKHORST",
"first_name": "SARA",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-07-01",
"last_updated": "2022-11-04",
"certification_date": "2022-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MI",
"license": "4301108468",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "NY",
"license": "293558",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MI",
"license": "4301507541",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "pcerecords.network180.x@direct.mihin.net",
"affiliation": "N",
"endpointDescription": "Direct Address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "790 Fuller Ave NE",
"city": "Grand Rapids",
"state": "MI",
"country_code": "US",
"postal_code": "495031918",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Nov 4, 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.
- 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.