JOSEPH YARED VANDEN BOSCH


Address: 4100 Lake Dr Se, Suite 305, Grand Rapids, MI 49546
Phone: 6162851377

JOSEPH YARED VANDEN BOSCH (NPI# 1457315095) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1457315095
Entity Type Individual
Full Name JOSEPH YARED VANDEN BOSCH
Credential MD
Practice Address 4100 Lake Dr Se
Suite 305
Grand Rapids
MI 49546
Mailing Address 61 Commerce Ave Sw
Grand Rapids
MI 49503-4124
Practice Telephone 6162851377
Practice Fax Number 6162851006
Mailing Telephone 6169400660
Mailing Fax Number 6169401965
Enumeration Date 2006-04-12
Last Update Date 2008-11-18
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 208VP0014X Pain Medicine
Specialization: Interventional Pain Medicine
4301066019 MI Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
PHYSICIANS HEALTH PLAN 2011679 01
MI 4552933-10 05
CIGNA 5211544 01
MI BCBSM 550411009 01
PRIORITY HEALTH 7000027001 01
UNITED HEALTH CARE 0000197359804 01
HEALTH PLAN OF MICHIGAN 19944 01
PRIORITY HEALTH MEDICAID 7000027001 01
RAILROAD MEDICARE 050076520 01
US DEPARTMENT OF LABOR 175884 01
MI 4532331-10 05
AETNA 7944423 01

Office Location

Street Address 4100 LAKE DR SE
SUITE 305
City GRAND RAPIDS
State MI
Zip Code 49546

Providers in the same location

NPI Name Taxonomy Address Enumeration
1366438632 Spectrum Health Hospitals Clinic/Center 4100 Lake Dr Se, Grand Rapids, MI 49546-8292 2005-09-22
1073146411 James Walejewski Specialist/Technologist 4100 Lake Dr Se, Grand Rapids, MI 49546-8292 2020-02-13
1811458557 Michelle Kuzma Specialist/Technologist 4100 Lake Dr Se, Grand Rapids, MI 49546-8292 2019-03-26
1063943991 Maggie Anstett Specialist/Technologist 4100 Lake Dr Se, Suite 300, Grand Rapids, MI 49546-8292 2017-03-22
1851746671 Luke Murray Specialist/Technologist 4100 Lake Dr Se, Suite 300, Grand Rapids, MI 49546-8292 2016-04-29
1942665237 Alyssa Susanne Baker Specialist/Technologist 4100 Lake Dr Se, Suite 300, Grand Rapids, MI 49546-8292 2015-12-31
1619332806 Elizabeth Albert Specialist/Technologist 4100 Lake Dr Se, Suite 300, Grand Rapids, MI 49546-8292 2015-12-15
1609247618 Rebecca Preston Psychologist 4100 Lake Dr Se, Suite B01, Grand Rapids, MI 49546-8292 2015-10-16
1255708921 Timothy Glerum Nurse Practitioner 4100 Lake Dr Se, Suite 205, Grand Rapids, MI 49546-8292 2015-08-28
1730556796 Samantha Ford Specialist/Technologist 4100 Lake Dr Se, Grand Rapids, MI 49546-8292 2015-08-26
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1437762986 Amanda Mae Ostrom Speech-Language Pathologist 710 Kenmore Ave Se, #110, Grand Rapids, MI 49546 2020-08-25
1063075562 Kelly Lynn Ibarra Counselor 4467 Cascade Road Se, Suite #4479, Grand Rapids, MI 49546 2019-04-19
1891257036 Jessica Matthews LLC Counselor 4127 Embassy Drive Se, Grand Rapids, MI 49546 2019-04-05
1326518531 Neah Morgan Technician 4220 Burton St Se, Grand Rapids, MI 49546 2018-11-29
1316430267 Michael John Benskey Case Manager/Care Coordinator 4065 Saladin St Se, Grand Rapids, MI 49546 2018-06-14
1679062772 Smile Cascade, P.C. Clinic/Center 4505 Cascade Rd Se # A, Grand Rapids, MI 49546 2018-05-03
1720583289 Jeromy Krogman Counselor 826 Parchment Drive Se, Grand Rapids, MI 49546 2018-03-27
1841792660 Affordable Hearing Clinic Hearing Instrument Specialist 833 Kenmoor Ave Se Ste G, Grand Rapids, MI 49546 2018-03-07
1689176133 Kelly Pines Physical Therapist 625 Kenmoor Ave Suite 306, Grand Rapids, MI 49546 2018-03-01
1467971440 Deanna Elizabeth Saenz Social Worker 2100 Raybrook St Se Ste 300, Grand Rapids, MI 49546 2017-09-12
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Taxonomy Information

Taxonomy Code 208VP0014X
Grouping Allopathic & Osteopathic Physicians
Classification Pain Medicine
Specialization Interventional Pain Medicine

Taxonomy Definition

Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1164664082 Javery Pain Institute PC Pain Medicine 710 Kenmoor Ave Se, Suite 200, Grand Rapids, MI 49546-2379 2009-03-25
1134186513 Bennett L Willard Pain Medicine 4100 Lake Dr Se, Suite 305, Grand Rapids, MI 49546 2006-04-28
1306803010 Daniel Mark Mankoff Pain Medicine 4100 Lake Dr Se, Suite 305, Grand Rapids, MI 49546 2006-04-27
1376509158 Stephen Lee Winston Pain Medicine 4100 Lake Dr Se, Suite 305, Grand Rapids, MI 49546 2006-04-21
1619930575 Thomas Michael Basch Pain Medicine 4100 Lake Dr Se, Ste 305, Grand Rapids, MI 49546 2006-04-10
1619938545 Mark Louis Gostine Pain Medicine 2060 E Paris Ave Se, Suite 200, Grand Rapids, MI 49546-6113 2006-03-30
1144281080 Kevin Edward Fitzgerald Pain Medicine 4100 Lake Dr Se, Ste 305, Grand Rapids, MI 49546 2006-03-30
1225099161 Fred Neal Davis Pain Medicine 2060 E Paris Ave Se, Suite 200, Grand Rapids, MI 49546-6113 2006-03-30
1225007206 Scott Howard Greenwald Pain Medicine 4100 Lake Dr Se, Suite 305, Grand Rapids, MI 49546 2006-03-14

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1558903294 Comprehensive Pain Specialists, Pllc Pain Medicine 4302 Bay City Rd, Midland, MI 48642-6014 2019-10-15
1437715232 Comprehensive Pain Specialists, Pllc Pain Medicine 705 E Frank St, Caro, MI 48723 2019-05-16
1083175913 Bella Treatment Center PC Pain Medicine 28763 Northwestern Hwy Ste 100, Southfield, MI 48034-1842 2019-03-25
1245795848 Advanced Pain Management Specialists, LLC Pain Medicine 46325 W 12 Mile Rd Ste 335, Novi, MI 48377-2464 2019-02-07
1356738686 Genesee Pain Associates PC Pain Medicine 4468 Oakbridge Dr, Flint, MI 48532-5422 2015-04-24
1457745150 Strategy Anesthesia Michigan Pllc Pain Medicine 13460 Fort St, Southgate, MI 48195-1138 2015-03-20
1407115884 Michiana Spine, Sports & Occupational Rehab, PC Pain Medicine 2500 Niles Rd Ste 3, Saint Joseph, MI 49085-3225 2012-05-07
1386902013 Michiana Spine, Sports & Occupational Rehab, PC Pain Medicine 24 N Saint Joseph Ave Ste B, Niles, MI 49120-2263 2012-05-01
1225302821 Pain Clinic Management Group, Pllc Pain Medicine 35634 Dequindre Rd, Sterling Heights, MI 48310-4288 2012-02-28
1740567163 Northville Pain Specialists Plc Pain Medicine 215 E. Main Street, Suite 201, Northville, MI 48167-1686 2011-11-14
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Competitor

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City GRAND RAPIDS
Zip Code 49546

Improve Information

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Dataset Information

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.

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