Individual provider Active NPI

Scott Leslie Vandevorde, DPM

  • Podiatrist
  • Holland, MI
National Provider Identifier
1992794200
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
SV001569 Issued in MI
Practice address
8957 Ottogan St
Holland, MI 49423-9044
Phone
(616) 748-9025
Fax
(616) 748-9124
NPI assigned
Oct 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X SV001569 MI Primary
Podiatrist 213E00000X 5901001567 MI

Addresses

Primary practice location

8957 Ottogan St
Holland, MI 49423-9044

Mailing address

430 E 8TH St
PMB 182
Holland, MI 49423-3751
Phone (616) 748-9025

Other identifiers 1

IdentifierTypeStateIssuer
4857059590OtherMIBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040817000036 MI Practitioner - Podiatry 5698748804 Reassigns benefits to 1 organization
Practice locations: Holland, MI; Spring Lake, MI; South Haven, MI; Muskegon, MI; Grand Rapids, MI; Fennville, MI; Byron Center, MI

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Onsight IncGroup PAC ID 6507938800, 27 clinicians

Practice addresses (Care Compare)

1200 Kirts Blvd
Suite 200
Troy, MI 48084-4899

2121 Raybrook St SE
Raybrook Manor Hfa
Grand Rapids, MI 49546-5793
Phone (616) 235-5469

2161 Leonard St NW
St Anns Home Al
Grand Rapids, MI 49504-3829
Phone (616) 453-7715

2567 W Grand Blvd
Boulevard Temple
Detroit, MI 48208-1235
Phone (313) 895-5340

400 Jeffery St
Cedar Springs, MI 49319-9572
Phone (616) 829-9702

7051 Madison Ave SE
Pine Rest Christian
Grand Rapids, MI 49548-7707
Phone (616) 281-6363

Merit-based Incentive Payment System (MIPS)

Final score
92.82 of 100Reported as group
Quality
61.63
Promoting interoperability
100
Improvement activities
40
Cost
81.1

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue2088
Removal or shaving of skin growth57

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5901001567MIMDPodiatrist
SV001569MIMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Onsight, Inc. CurrentSince Sep 3, 2011 Accepting new patients
Onsight, Inc. Podiatrist CurrentSince Sep 3, 2011 Accepting new patients
Giaimo Mobile Podiatry of WV PLLC Podiatrist Past Accepting new patients
Age Management of West Michigan PC Past Accepting new patients
Ahsl Holland Operations, LLC Past Accepting new patients

Locations

2567 W Grand Blvd
Detroit, MI 48208
Phone (313) 895-2990

601 Abbott Rd
East Lansing, MI 48823
Phone 24852821166

1450 Fulton St E
Grand Rapids, MI 49503
Phone (616) 643-2600

2121 Raybrook St SE
Grand Rapids, MI 49546
Phone (616) 235-5002

1200 Kirts Blvd
Ste 200
Troy, MI 48084
Phone 24852819814031

100 W Big Beaver Rd
Ste 655
Troy, MI 48084
Phone (248) 528-1857

Interoperability endpoints

  • Direct secure messaging: scott.vandevorde.p16@direct.360care.nextgenshare.com

Organizations & group practices 5

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": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1992794200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 E 8TH ST",
            "address_2": "PMB 182",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494233751",
            "telephone_number": "616-748-9025",
            "fax_number": "616-748-9124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8957 OTTOGAN ST",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494239044",
            "telephone_number": "616-748-9025",
            "fax_number": "616-748-9124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDEVORDE",
        "first_name": "SCOTT",
        "middle_name": "LESLIE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "SV001569",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "5901001567",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4857059590",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.