Organization Active NPI

Ronald Vanderlaan, MD, PLLC

Doing business as Greater Cardiology

  • Cardiovascular Disease Physician
  • Grand Rapids, MI
National Provider Identifier
1942482641
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
4301046234 Issued in MI
Legal business name
RONALD VANDERLAAN, MD, PLLC
Practice address
655 Kenmoor Ave SE Ste 101
Grand Rapids, MI 49546-8622
Phone
(616) 900-9911
Fax
(616) 900-9862
NPI assigned
Dec 4, 2007
Last updated
Dec 17, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Authorized official

Name
Ms. Cynthia Lynn Szott
Title
Billing Manager
Phone
(616) 900-9911

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 4301046234 MI Primary

Addresses

Primary practice location

655 Kenmoor Ave SE Ste 101
Grand Rapids, MI 49546-8622

Mailing address

655 Kenmoor Ave SE Ste 101
Grand Rapids, MI 49546-8622
Phone (616) 900-9911

Other identifiers 1

IdentifierTypeStateIssuer
1942482641MedicaidMI

Other names 1

  • Greater Cardiology Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080222000198 MI Part B Supplier - Clinic/Group Practice 0143304667 Receives reassigned benefits from 3 practitioners
Practice locations: Grand Rapids, MI

National Provider Directory

National Provider Directory

Locations

1310 E Beltline Ave SE
Ste 130
Grand Rapids, MI 49506
Phone (616) 717-5141

1900 Wealthy St SE
Ste 380
Grand Rapids, MI 49506
Phone (616) 307-3638

655 Kenmoor Ave SE
Ste 101
Grand Rapids, MI 49546
Phone (616) 900-9911

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639699200000",
    "number": "1942482641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 KENMOOR AVE SE STE 101",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468622",
            "telephone_number": "616-900-9911",
            "fax_number": "616-900-9862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 KENMOOR AVE SE STE 101",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468622",
            "telephone_number": "616-900-9911",
            "fax_number": "616-900-9862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONALD VANDERLAAN, MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-04",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A",
        "authorized_official_last_name": "SZOTT",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "616-900-9911",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301046234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942482641",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greater Cardiology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Greater Cardiology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Greater Cardiology",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Dec 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.