Matthew Vandemortel, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

601 Elmwood Ave FL 416
Rochester, NY 14642-5988

Phone

(585) 275-5276

NPI assigned

Jun 18, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: mvandemortel11962@mvhealthsystem.direct-ci.com

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.

• Central New York Cardiology, PC

  • Cardiovascular Disease Physician
  • Utica, NY
  • NPI 1750339412
  Medicare reassignment
• University Cardiothoracic Surgery Group

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Rochester, NY
  • NPI 1154342285
  Medicare reassignment

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

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599264000000",
    "number": "1962996520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3098 JOHNSON RD",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144569522",
            "telephone_number": "315-237-7211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE FL 416",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146425988",
            "telephone_number": "585-275-5276"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2211 Genesee St Fl 2",
            "address_purpose": "LOCATION",
            "city": "Utica",
            "state": "NY",
            "postal_code": "135015988",
            "country_code": "US",
            "telephone_number": "315-733-7598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDEMORTEL",
        "first_name": "MATTHEW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-18",
        "last_updated": "2020-09-05",
        "certification_date": "2020-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Elizabeth Vancott, PHARMD
• Alexander J Vandamme, M.D.
• Glen J Vandebogart, RPH
• Carly Judith Vandegriff, MA
• Jamie Vandelinder-Pierce, ADVANCED CASAC
• Miranda Vander Horst, FNP
• Grace Vander Molen
• Mike Vanderlan
• Robert Edward Vanderlinde, M.D.
• Sarah Vanderlinde, MD

• Physician Assistant in Rochester, NY
• Providers in Rochester, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.