DR. TIMOTHY GERARD II VANDENBOOM (M.D.) – Dermatopathology Physician, NPI 1629344189
Dermatopathology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
767 PATHOLOGY in IL
Provider Addresses for DR. TIMOTHY GERARD II VANDENBOOM (M.D.)
676 N SAINT CLAIR ST
SUITE 1765
CHICAGO, IL 606112927
Phone: (312) 695-1413
Type: Mailing
5301 E HURON RIVER DR
YPSILANTI, MI 481971051
Phone: (734) 712-3161
Type: Location
676 N Saint Clair St
Suite 1765
Chicago, IL 606112927
Phone: (312) 695-1413
Type: Location
1314 N Macomb St
Monroe, MI 481623131
Phone: (800) 746-5870
Type: Location
24 FRANK LLOYD WRIGHT DR LBBY J2000
ANN ARBOR, MI 481059484
Phone: (734) 747-6766
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $46.
Total Amount is formed as General ($46) + Research ($0) + Ownership ($0) = $46.
Last reported payment date: 2024-10-09 • Largest payer in this snapshot: Roche Diagnostics Corporation ($46).
Total Amount
$46
General + Research + Ownership
Payments
1
Total payment records
General Amount
$46
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-09
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Roche Diagnostics Corporation | $46 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2018-07-09
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20180709002136 | I | Pathology | MI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 1,684 | 1,230 | $0 |
| 88304 | Pathology examination of tissue using a microscope, moderately low complexity | 136 | 125 | $0 |
| 88312 | Special stained specimen slides to identify organisms including interpretation and report | 105 | 97 | $0 |
| 88341 | Special stained specimen slides to examine tissue, each additional procedure | 86 | 40 | $0 |
| 88342 | Special stained specimen slides to examine tissue, initial procedure | 78 | 72 | $0 |
Insurance plans in this area (ZIP 60611)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Hospitalist, Internal Medicine | MI | |
| Interventional Radiology | MI | |
| Cardiovascular Disease (Cardiology) | MI | |
| Physician Assistant | MI | |
| Physician Assistant | MI | |
| - | MI | |
| - | MI | |
| Internal Medicine, Geriatric Medicine | MI | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MI | |
| Hospitalist, Internal Medicine | MI |
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