Individual provider Active NPI

Michael Vander Meulen

  • Emergency Medicine Physician
  • Boston, MA
National Provider Identifier
1972802767
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
C171391 Issued in CA
Practice address
75 Francis St
Boston, MA 02115-6110
Phone
(617) 732-8070
NPI assigned
Mar 20, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Q3120 TX
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X C171391 CA Primary

Addresses

Primary practice location

75 Francis St
Boston, MA 02115-6110

Mailing address

424 Brookside Dr SE
Grand Rapids, MI 49507-3558
Phone (616) 648-7550

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20211104003199 CA Practitioner - Emergency Medicine 1153588900 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HMH Emergency Medical Group, Inc.Group PAC ID 7911800826, 56 clinicians
Exer Medical CorporationGroup PAC ID 9032359534, 336 clinicians

Practice addresses (Care Compare)

100 W California Blvd
Pasadena, CA 91105-3010
Phone 6264470296142

26777 Agoura Rd
Suite B4
Calabasas, CA 91302-2967
Phone (818) 880-2225

475 Foothill Blvd
Suite K
La Canada, CA 91011-3555
Phone (818) 528-6377

797 S Fair Oaks Ave
Suite 100
Pasadena, CA 91105-2617
Phone (626) 385-1455

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.41 of 100Reported as group
Quality
79.31
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C171391CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Exer Medical Corporation CurrentSince Sep 4, 2023 Accepting new patients
Valley Presbyterian Emergency Medical Associates Emergency Medicine CurrentSince Aug 1, 2021 Accepting new patients
HMH Emergency Medical Group, Inc. Emergency Medicine CurrentSince Sep 1, 2023 Accepting new patients
Grand Avenue Emergency Physicians Medical Group Inc Emergency Medicine CurrentSince Dec 1, 2021 Accepting new patients
Methodist Health Centers Past Accepting new patients
Huntington Memorial Hospital Past Accepting new patients

Locations

831 S State College Blvd
Anaheim, CA 92806
Phone (714) 533-2273

2215 Truxtun Ave
Bakersfield, CA 93301
Phone (661) 477-9283

26777 Agoura Rd
Ste 4
Calabasas, CA 91302
Phone (818) 880-2225

26777 Agoura Rd
Calabasas, CA 91302
Phone (818) 880-2225

235 E 17th St
Costa Mesa, CA 92627
Phone (949) 688-2010

2381 Rosecrans Ave
Ste 115
El Segundo, CA 90245
Phone (213) 335-7355

7000 Boulder Ave
Ste 103
Highland, CA 92346
Phone (515) 441-6271

100 W California Blvd
Pasadena, CA 91105
Phone (626) 397-3445

25548 The Old Rd
Ste U1
Stevenson Ranch, CA 91381
Phone (661) 556-9020

701 N Wendy Dr
Thousand Oaks, CA 91320
Phone (805) 375-4400

15107 Vanowen St
Van Nuys, CA 91405
Phone (818) 782-6600

23341 Mulholland Dr
Woodland Hills, CA 91364
Phone (818) 637-0048

Interoperability endpoints

  • Direct secure messaging: mvandermeulen451944@direct.cshs.org

Organizations & group practices 6

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 1

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": "1300579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1972802767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 BROOKSIDE DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495073558",
            "telephone_number": "616-648-7550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156110",
            "telephone_number": "617-732-8070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDER MEULEN",
        "first_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-20",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "Q3120",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "C171391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.