Individual provider Active NPI

Andrew Joseph Vaughan, D.O.

  • Surgery Physician
  • Saint Joseph, MI
National Provider Identifier
1932634607
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
5101026883 Issued in MI
Practice address
1234 Napier Ave
Saint Joseph, MI 49085-2112
Phone
(269) 429-0900
NPI assigned
May 1, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 82877 MN
Surgery Physician 208600000X 5101022993 MI
Surgery Physician 208600000X 5101026883 MI Primary

Addresses

Primary practice location

1234 Napier Ave
Saint Joseph, MI 49085-2112

Mailing address

1234 Napier Ave
Saint Joseph, MI 49085-2112
Phone (269) 429-0900

Other practice location 1

100 Michigan St NE
Grand Rapids, MI 49503-2560
Phone (866) 989-7999

Other practice location 2

1010 W North Down River Rd
Grayling, MI 49738-2060
Phone (989) 248-0800

Other practice location 3

927 S Carmel St
Cadillac, MI 49601-2547
Phone (231) 876-3876

Other practice location 4

28050 Grand River Ave
Suite 208 North
Farmington Hills, MI 48336-5919
Phone (248) 471-8865

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, CO, WI3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20240105002719 MI Practitioner - Critical Care (Intensivists)Practitioner - General Surgery 5991185332 Reassigns benefits to 2 organizations
I20260430001070 CO Practitioner - General Surgery 5991185332 Reassigns benefits to 1 organization
I20260513002758 WI Practitioner - General Surgery 5991185332 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: General Surgery
Education
Rocky Vista University College of Osteopathic Med, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560

1234 Napier Ave
Corewell Health Lakeland Hospitals
Saint Joseph, MI 49085-2112
Phone (269) 983-8300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101022993MIMDSurgery Physician
5101026883MIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Medical Practices CurrentSince Dec 4, 2023 Accepting new patients
Lakeland Hospitals at Niles and St Joseph, Inc CurrentSince Aug 19, 2024 Accepting new patients
Lakeland Medical Practices CurrentSince Dec 4, 2023 Accepting new patients
Lakeland Hospitals at Niles and St Joseph, Inc CurrentSince Aug 19, 2024 Accepting new patients

Locations

100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680

31 N Saint Joseph Ave
Niles, MI 49120
Phone (269) 428-2417

3900 Hollywood Rd
Saint Joseph, MI 49085
Phone (269) 428-4411

3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990

1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941

Organizations & group practices 7

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.

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": "1493596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1932634607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 NAPIER AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852112",
            "telephone_number": "269-429-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 NAPIER AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852112",
            "telephone_number": "269-429-0900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Michigan St NE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495032560",
            "country_code": "US",
            "telephone_number": "866-989-7999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1010 W North Down River Rd",
            "address_purpose": "LOCATION",
            "city": "Grayling",
            "state": "MI",
            "postal_code": "497382060",
            "country_code": "US",
            "telephone_number": "989-248-0800",
            "fax_number": "989-344-5725",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "927 S Carmel St",
            "address_purpose": "LOCATION",
            "city": "Cadillac",
            "state": "MI",
            "postal_code": "496012547",
            "country_code": "US",
            "telephone_number": "231-876-3876",
            "fax_number": "231-775-1115",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "28050 Grand River Ave",
            "address_2": "Suite 208 North",
            "address_purpose": "LOCATION",
            "city": "Farmington Hills",
            "state": "MI",
            "postal_code": "483365919",
            "country_code": "US",
            "telephone_number": "248-471-8865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAUGHAN",
        "first_name": "ANDREW",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-01",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "82877",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "5101022993",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "5101026883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

Verify at the official NPI Registry.