DR. THOMAS R VANDERHEYDEN JR. D.O.
NPI 1528222387
Internal Medicine in South Bend, IN

Q: What is Thomas Vanderheyden's NPI number?

The NPI number for Thomas Vanderheyden is 1528222387. It was assigned to this individual provider in the NPPES registry on July 10, 2008.

Q: What is Thomas Vanderheyden's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Active since July 10, 2008PECOS EnrolledAccepts Medicare Assignment

63.68/100

CMS Quality Rating

17501 GENERATIONS DR, SOUTH BEND, IN 46635(574) 234-0049 Get Directions Write a Review

NPPES record last updated: August 28, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Dr. Thomas R Vanderheyden Jr. D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. THOMAS R VANDERHEYDEN JR. D.O. (NPI 1528222387) is an individual internal medicine provider in South Bend, Indiana, licensed in Indiana (02004009A) and active in the NPI registry since July 2008. He is enrolled in Medicare PECOS, is affiliated with Saint Joseph Regional Medical Center, and is a graduate of Midwestern University, Chicago College Of Osteopathic Med (2006).

NPPES Registry Identity

NPI1528222387

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameDR. THOMAS R VANDERHEYDEN JR.Credential: D.O.

Location Address17501 GENERATIONS DRSouth Bend, IN 46635-1589

Mailing Address17501 Generations DrSouth Bend, IN 46635-1589 · (574) 234-0049

Phone(574) 234-0049

Sole ProprietorNo

Medical School CMSMidwestern University, Chicago College Of Osteopathic MedGraduated 2006

Enumeration DateJuly 10, 2008

Last NPPES UpdateAugust 28, 2012

✔ NPI 1528222387 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Licenses✔ Licensed in IN · 02004009A✔ Licensed in IL · 125-050866

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

17501 GENERATIONS DR, South Bend, IN 46635

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Other Identifiers 3

Medicaid201066120IN

Medicare PINM400074474IN

Other000000777772IN · Anthem

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Thomas R Vanderheyden Jr. D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7113183088

PECOS Enrollment IDI20120720000240

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 16

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

206 services206 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

156 services150 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

81 services76 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

75 services74 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

72 services70 patients

Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43235

This procedure, known as an upper endoscopy, involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like ulcers or inflammation.

43 services43 patients

Insertion of guide wire with dilation of esophagus using a flexible endoscope 43248

This is a procedure where a thin tube, called an endoscope, is gently passed through your mouth into your esophagus. A guide wire is then inserted to help widen any narrow areas. This helps improve swallowing and reduce discomfort.

41 services36 patients

Diagnostic exam of large bowel using a flexible endoscope 45378

This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.

41 services41 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

34 services33 patients

Colorectal cancer screening; colonoscopy on individual at high risk G0105

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

32 services32 patients

Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm 43249

This procedure involves using a flexible tube with a camera, called an endoscope, to gently expand narrowed areas in your esophagus, stomach, or upper small bowel. A small balloon is inflated, making it easier for food and liquid to pass through. It's safe and effective.

31 services31 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

27 services27 patients

Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk G0121

Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.

26 services26 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

21 services21 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

14 services12 patients

Injection beneath lining of large bowel using a flexible endoscope 45381

This procedure involves a flexible tube, called an endoscope, being inserted into the large bowel. A small needle is then passed through the tube to inject medication under the bowel lining. This is typically done to treat inflammation or bleeding.

11 services11 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Saint Joseph Regional Medical Center

Acute Care Hospitals · Mishawaka, IN

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150012

Location5215 Holy Cross PkwyMishawaka, IN 46545 · St. Joseph County

Emergency services Birthing friendly

Elkhart General Hospital

Acute Care Hospitals · Elkhart, IN

4/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number150018

Location600 E BlvdElkhart, IN 46514 · Elkhart County

Emergency services Birthing friendly

Memorial Hospital Of South Bend

Acute Care Hospitals · South Bend, IN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150058

Location615 N Michigan StSouth Bend, IN 46601 · St. Joseph County

Emergency services Birthing friendly

Saint Joseph Regional Medical Center - Plymouth

Acute Care Hospitals · Plymouth, IN

2/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number150076

Location1915 Lake AvePlymouth, IN 46563 · Marshall County

Emergency services

Community Hospital Of Bremen Inc

Critical Access Hospitals · Bremen, IN

OwnershipVoluntary non-profit - Private

CMS Certification Number151300

Location1020 High RdBremen, IN 46506 · Marshall County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46635 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$122.49 typical visit price

range $53.07 – $161.76

Typical copayment $30.62 (range $13.26 – $40.44)

Most-billed visit code 99204

Established Patient

$94.22 typical visit price

range $16.93 – $132.22

Typical copayment $23.55 (range $4.23 – $33.05)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

63.68/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

54.73

Improvement Activities

Cost

39.31

Reported Quality Measures

Closing the Referral Loop: Receipt of Specialist Report

15%67 patients1/55-star benchmark: 87%

Colorectal Cancer Screening

50%506 patients3/55-star benchmark: 88%

Controlling High Blood Pressure

37%292 patients2/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

33%1,120 patients1/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

0%377 patients1/55-star benchmark: 100%

HIV Screening

0%534 patients1/55-star benchmark: 60%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

54%863 patients3/55-star benchmark: 98%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

5%1,120 patients1/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 59% · 893 patients

Patients screened: 88% · 893 patients

1%176 patients1/55-star benchmark: 100%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 0% · 377 patients

Patients totalRate: 1% · 377 patients

1%377 patients4/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. PANKAJ A PATEL M.D.

Internal Medicine (Gastroenterology)