Logan Taylor Vander Woude, DO, MPH

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

OS17574 Issued in FL

Practice address

3500 US Highway 1
Vero Beach, FL 32960-4511

Phone

(772) 299-1404

NPI assigned

Apr 15, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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 1

Specialty

Ophthalmology

Education

Nova Southeastern College of Osteo Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

William J. Mallon, MDGroup PAC ID 9234039116, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cleveland Clinic Indian River Hospital Hospital, Vero Beach, FL, CCN 100105
• HCA Florida Lawnwood Hospital Hospital, Fort Pierce, FL, CCN 100246

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lvanderwoude333262@direct.shands.ufl.edu

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.

• William J. Mallon, MD

  • Ophthalmology Physician
  • Vero Beach, FL
  • NPI 1649353582
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Indian River Memorial Hospital Inc

  • General Acute Care Hospital
  • Vero Beach, FL
  • NPI 1376512988
  Care Compare affiliation
• Lawnwood Medical Center Inc

  • General Acute Care Hospital
  • Fort Pierce, FL
  • NPI 1568409647
  Care Compare affiliation

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

{
    "created_epoch": "1492214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1972037018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 US HIGHWAY 1",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604511",
            "telephone_number": "772-299-1404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 US HIGHWAY 1",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604511",
            "telephone_number": "772-299-1404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2215 Nebraska Ave Ste 2-H",
            "address_purpose": "LOCATION",
            "city": "Fort Pierce",
            "state": "FL",
            "postal_code": "349504866",
            "country_code": "US",
            "telephone_number": "772-299-1404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDER WOUDE",
        "first_name": "LOGAN",
        "middle_name": "TAYLOR",
        "credential": "DO, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-15",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS17574",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "OS17574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "OS17574",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Virginia Van Arsdall, CNM
• Mary-Therese C Van Hollenbeck, MA.,BCBA
• Wakako Van Weezel
• Van-Leigh of Vero Beach, LLC
• Julie Sophia Vanags, PTA
• Jamie Varner
• Mary Frances Varsegi, M.D.
• Catalin Vasiliu
• Salvatore Vassallo III, DO
• Natalie Theresa Vasu, PA-C

• Ophthalmology Physician in Vero Beach, FL
• Providers in Vero Beach, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.

Verify at the official NPI Registry.