Active NPI
Lope Alvaran Vitangcol Jr., M.D.
- Surgery Physician
- Watervliet, MI
National Provider Identifier
1962480228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 4301040457
- Practice address
- 450 Medical Park Dr
Suite 100
Watervliet, MI 49098-8531 - Phone
- (269) 463-6490
- Fax
- (269) 463-6454
- NPI assigned
- Jan 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 4301040457 | MI | Primary |
Addresses
Primary practice location
450 Medical Park Dr
Suite 100
Watervliet, MI 49098-8531
Mailing address
8740 N Bluffview Dr
Berrien Springs, MI 49103-1490
Phone (269) 473-3402
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101418979 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lope a Vitangcol Jr MD PC | Surgery | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317340800000",
"number": "1962480228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8740 N BLUFFVIEW DR",
"city": "BERRIEN SPRINGS",
"state": "MI",
"postal_code": "491031490",
"telephone_number": "269-473-3402",
"fax_number": "269-463-6454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 MEDICAL PARK DR",
"address_2": "SUITE 100",
"city": "WATERVLIET",
"state": "MI",
"postal_code": "490988531",
"telephone_number": "269-463-6490",
"fax_number": "269-463-6454"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VITANGCOL",
"first_name": "LOPE",
"middle_name": "ALVARAN",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-06",
"last_updated": "2011-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MI",
"license": "4301040457",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "101418979",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Watervliet, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.