JAMES MICHAEL VANDAELE (NPI# 1396122883) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396122883 |
| Entity Type | Individual |
| Full Name | JAMES MICHAEL VANDAELE |
| Credential | PA-C |
| Practice Address |
17877 W 14 Mile Rd Beverly Hills MI 48025 |
| Mailing Address |
17877 W 14 Mile Rd Beverly Hills MI 48025-3127 |
| Practice Telephone | 2486443920 |
| Practice Fax Number | 2486442569 |
| Mailing Telephone | 2486443920 |
| Mailing Fax Number | 2486442569 |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2018-06-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
5601008593 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
018604 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | CONTROLLED SUBSTANCE LICENSE | 5315090542 | 01 |
| MI | PHYSICIAN ASSISTANT LICENSE FOR THE STATE OF MICHIGAN | 5601008593 | 01 |
| Street Address |
17877 W 14 MILE RD |
| City | BEVERLY HILLS |
| State | MI |
| Zip Code | 48025 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043292964 | J Michael Wiater | Orthopaedic Surgery | 17877 W 14 Mile Rd, Beverly Hills, MI 48025-3127 | 2005-11-16 |
| 1730601162 | Michael William-mulligan Wille | Physician Assistant | 17877 W 14 Mile Rd, Beverly Hills, MI 48025 | 2017-07-07 |
| 1841738648 | Michigan Orthopaedic Surgeons Pllc | Orthopaedic Surgery | 17877 W 14 Mile Rd, Beverly Hills, MI 48025-3127 | 2017-02-01 |
| 1396140166 | Jamie Leigh Szkodzinski | Physician Assistant | 17877 W 14 Mile Rd, Beverly Hills, MI 48025-3127 | 2014-10-23 |
| 1578991295 | Brett P Wiater Md PC | Orthopaedic Surgery | 17877 W 14 Mile Rd, Beverly Hills, MI 48025-3127 | 2013-10-15 |
| 1871807297 | Marilyn Adair Corrigan | Occupational Therapist | 17877 W 14 Mile Rd, Beverly Hills, MI 48025-3127 | 2010-07-27 |
| 1154432714 | Brett Peter Wiater | Orthopaedic Surgery | 17877 W 14 Mile Rd, Beverly Hills, MI 48025-3127 | 2006-08-31 |
| 1649248931 | Gregory Victor Sobol | Orthopaedic Surgery | 17877 W 14 Mile Rd, Beverly Hills, MI 48025 | 2006-03-10 |
| 1952383879 | Patrick J Wiater | Orthopaedic Surgery | 17877 W 14 Mile Rd, Beverly Hills, MI 48025-3127 | 2005-11-16 |
| 1265414189 | Thomas D Magnell | Orthopaedic Surgery | 17877 W 14 Mile Rd, Beverly Hills, MI 48025-3127 | 2005-11-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518571413 | Cole Nicolas Gomez | Technician/Technologist | 32199 Telegraph Rd, Bingham Farms, MI 48025 | 2020-09-08 |
| 1346859212 | Jordyn Jones | Technician/Technologist | 32199 Telegraph Rd Ste 205, Bingham Farms, MI 48025 | 2020-07-27 |
| 1013492644 | Shaniya Hyman | Technician/Technologist | 32100 Telegraph Rd Suit 205, Bingham Farms, MI 48025 | 2018-09-28 |
| 1043799042 | Assisted Home Health | Hospice Care, Community Based | 20150 Plantation Ln, Beverly Hills, MI 48025 | 2018-08-09 |
| 1235618224 | Robert Dean Harley | Technician/Technologist | 31200 Telegraph Rd Ste 205, Bingham Farms, MI 48025 | 2018-08-09 |
| 1760973911 | Tailormed Medical Inc | Case Management | 30100 Telegraph Road, Suite 403, Bringham Farms, MI 48025 | 2018-05-23 |
| 1245745447 | Supportive Home Health Care LLC | Home Health | 30100 Telegraph Rd Ste 478, Bingham Farms, MI 48025 | 2017-12-11 |
| 1265954192 | Breeona Rue | Technician/Technologist | 32100 Telegraph Rd Suite 205, Bingham Farms, MI 48025 | 2017-07-12 |
| 1417478132 | Gina Maria Bignotti | Behavior Technician | 32100 Telegraph, Bingham Farms, MI 48025 | 2017-07-03 |
| 1295256238 | Chanel Matti | Behavior Technician | 32100 Telegraph Rd Suite 185, Bingham Farms, MI 48025 | 2017-06-29 |
| Find all providers in zip 48025 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699121038 | Caitlin Pray | Physician Assistant | 250 N Robertson Blvd, Ste 506, Beverly Hills, CA 90211-1788 | 2016-05-04 |
| 1871983114 | Kristy Eumont | Physician Assistant | 462 N Linden Dr, Suite 240, Beverly Hills, CA 90212 | 2015-01-26 |
| 1265871727 | Megan A. Selig Physician Assistant Inc. | Physician Assistant | 9033 Wilshire Blvd, Suite 400, Beverly Hills, CA 90211-1837 | 2013-06-18 |
| 1811280324 | Natalie R Bricker | Physician Assistant | 8670 Wilshire Blvd, Suite # 202, Beverly Hills, CA 90211-2924 | 2011-05-17 |
| 1245548825 | Jerome L Hansen | Physician Assistant | 2155 W Mustang Blvd, Beverly Hills, FL 34465 | 2010-09-17 |
| 1043457344 | Dr Robert M Rey | Physician Assistant | 436 N Bedford Dr, Suite 304, Beverly Hills, CA 90210-4310 | 2009-01-08 |
| 1700909108 | Orla Stewart | Physician Assistant | 465 N Roxbury Dr, Ste 1001, Beverly Hills, CA 90210-4206 | 2007-04-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841835303 | Gerard M Lefebvre Jr. | Physician Assistant | 5301 Mcauley Dr Ste 5112, Ypsilanti, MI 48197-1051 | 2019-11-08 |
| 1548611023 | Michael Scott Schaeffer II | Physician Assistant | 58070 Montego Dr, New Hudson, MI 48165-9735 | 2016-06-27 |
| 1700248176 | Katilyn Kohl | Physician Assistant | 3990 John R St Ste 4905, Detroit, MI 48201-2018 | 2016-03-24 |
| 1881052363 | Surgical Assist, Plc | Physician Assistant | 4409 Gaylord Dr, Troy, MI 48098-4458 | 2016-01-29 |
| 1710342134 | Evan Reid Vandenbosch | Physician Assistant | 36622 5 Mile Rd, Suite 101, Livonia, MI 48154-1900 | 2015-12-30 |
| 1619368008 | Matthew Eisen | Physician Assistant | 1560 E Sherman Blvd Ste 9, Muskegon, MI 49444-1867 | 2015-02-06 |
| 1609214972 | Jennifer Lynn Krishnan | Physician Assistant | 3601 E 13 Mile Rd, Royal Oak, MI 48073-6769 | 2013-06-10 |
| 1093028441 | Lonna Petronella Van Ast | Physician Assistant | 1022 Ada Place Dr Se, Grand Rapids, MI 49546-3786 | 2010-07-14 |
| 1669707170 | Luke Thomas Dillon | Physician Assistant | 3100 Cross Creek Pkwy Ste 200, Auburn Hills, MI 48326-2776 | 2009-10-16 |
| 1912139544 | Richard Lawrence Burgett Sr. | Physician Assistant | 4327 Stone Ridge Dr, Traverse City, MI 49684-7958 | 2009-08-15 |
| Find all providers with the same taxonomy | ||||
| City | BEVERLY HILLS |
| Zip Code | 48025 |
Please comment or provide details below to improve the information on JAMES MICHAEL VANDAELE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.