MR. DOUGLAS LEE VANDER WOUDE (MD) – Plastic Surgery Physician, NPI 1235133653

MR. DOUGLAS LEE VANDER WOUDE (MD) is a healthcare provider. based in Grand rapids, Michigan. specializing in PLASTIC AND RECONSTRUCTIVE SURGERY. They hold the professional credentials MD. They hold a License No. 4301407024 (MI). The NPI Number for MR. DOUGLAS LEE VANDER WOUDE (MD) is 1235133653

Main info

Male
40 Years Of Experience
Accepts Medicare Assignment
Name
MR. DOUGLAS LEE VANDER WOUDE (MD)
NPI
1235133653
Phone
(616) 451-4500
Address
220 LYON ST NW
Enumeration Date
13 June 2005
Last Update Date
11 May 2020

Doctor Profile

Medical School Name
UNIVERSITY OF MICHIGAN MEDICAL SCHOOL
Secondary Phone
6164514500
Graduation Year
1986 (40 years ago)
PAC ID
0547237604
Group Practice PAC ID
1456300300
Professional Enrollment ID
I20040916000919
Address ID
MI495032210GR220XXNWXX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

247 PLASTIC AND RECONSTRUCTIVE SURGERY in MI

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Provider Addresses for MR. DOUGLAS LEE VANDER WOUDE (MD)

  • 220, Lyon Street Northwest, Grand Rapids, Kent County, Michigan, 49503, United States

    STE 700

    GRAND RAPIDS, MI 495032210

    Phone: (616) 451-4500

    Fax: (616) 451-9077

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 17 Open Payments records for all available years, with a total value of $506.

Total Amount is formed as General ($506) + Research ($0) + Ownership ($0) = $506.

Last reported payment date: 2024-12-04 • Largest payer in this snapshot: ABBVIE INC. ($466).

Total Amount

$506

General + Research + Ownership

Payments

17

Total payment records

General Amount

$506

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-04

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2004-09-16

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040916000919IPlastic And Reconstructive SurgeryMITBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49503)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1456300300View full group profile
NameSpecialtyState
Plastic And Reconstructive SurgeryMI
Plastic And Reconstructive SurgeryMI

Reviews

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Frequently asked questions

What NPI should I save for MR. DOUGLAS LEE VANDER WOUDE (MD)?
Save NPI 1235133653 if you need a stable reference for MR. DOUGLAS LEE VANDER WOUDE (MD).
Is MR. DOUGLAS LEE VANDER WOUDE (MD)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does MR. DOUGLAS LEE VANDER WOUDE (MD) work in?
You can think of MR. DOUGLAS LEE VANDER WOUDE (MD) as practicing within Plastic Surgery Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for MR. DOUGLAS LEE VANDER WOUDE (MD)?
The page summarizes Grand Rapids, Michigan for MR. DOUGLAS LEE VANDER WOUDE (MD); expand the address list for detail.
How can I contact MR. DOUGLAS LEE VANDER WOUDE (MD)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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