Deactivated NPI 1639174063 Deactivated / Inactive NPI Male Practitioner

Dr. Thomas L Vander Laan , MD

Specialist • Pasadena, CA

⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Thomas Vander Laan has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date June 13, 2005

NPI Deactivation Date March 17, 2006

Total Practice Duration ~1 Years of Practice (2005 – 2006)

Professional Overview & Biography Verified Profile Summary

Dr. Thomas Vander Laan, MD was a registered Specialist practicing in Pasadena, CA. Throughout an active medical career spanning 1 years, Dr. Vander Laan provided care at the practice location at 50 BELLEFONTAINE ST until profile deactivation on 2006-03-17.

Historical Medicare Part B clinical services included removal of skin and tissue, 20.0 sq cm or less, established patient outpatient office visit, removal of skin and tissue. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

50 Bellefontaine St
Ste 303

Pasadena, CA 911053132

Telephone 6267934136

Fax 6267938279

Associated Practice Facility / Clinic

🏢 Fairmont Pharmacy Llc Facility NPI 1043249105

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Pasadena, CA

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 33.3 Yrs

State Avg: 38.0 Yrs

Regional Practice Density

45 Specialists

Practicing in Pasadena, CA (6446 Statewide)

Telehealth Adoption Rate

8.9% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

57.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
11042 Removal of skin and tissue, 20.0 sq cm or less	271	80	$130.00	$62.50
99213 Established patient office or other outpatient visit, typically 15 minutes	199	80	$200.00	$68.30
11045 Removal of skin and tissue, each additional 20.0 sq cm or less	195	61	$53.00	$25.43
99183 Management and supervision of oxygen chamber therapy per session	132	16	$225.00	$107.65
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	68	68	$250.00	$84.43
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	66	42	$280.00	$100.64
97597 Removal of tissue from wound, 20.0 sq cm or less	45	21	$75.00	$36.06
97598 Removal of tissue from wound, each additional 20.0 sq cm	29	15	$52.00	$25.00
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	19	11	$330.00	$150.49
11044 Removal of bone, 20.0 sq cm or less	17	12	$475.00	$230.62
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	14	14	$365.00	$137.71

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
11042 Removal of skin and tissue, 20.0 sq cm or less	271	51	$156.45	$63.04
99213 Established patient office or other outpatient visit, typically 15 minutes	228	50	$184.19	$69.48
99183 Management and supervision of oxygen chamber therapy per session	115	18	$225.00	$110.23
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	108	37	$240.69	$125.12
11045 Removal of skin and tissue, each additional 20.0 sq cm or less	69	18	$59.81	$26.09
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	57	28	$116.74	$37.31
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	24	24	$244.67	$86.79
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	11	11	$326.82	$140.01

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
11042 Removal of skin and tissue, 20.0 sq cm or less	198	51	$237.00	$64.17
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	148	34	$88.00	$38.70
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	108	39	$160.00	$75.39
99213 Established patient office or other outpatient visit, typically 15 minutes	95	37	$147.00	$71.37
11045 Removal of skin and tissue, each additional 20.0 sq cm or less	77	17	$100.00	$27.67
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	45	30	$221.33	$109.04
99213 Established patient office or other outpatient visit, typically 15 minutes	30	15	$147.00	$99.97
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	25	25	$218.00	$88.97

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
11042 Removal of skin and tissue, 20.0 sq cm or less	149	33	$237.00	$65.57
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	115	25	$88.00	$38.81
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	73	28	$160.00	$76.84
99213 Established patient office or other outpatient visit, typically 15 minutes	54	19	$147.00	$72.73
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	45	27	$219.44	$110.45
99213 Established patient office or other outpatient visit, typically 15 minutes	29	15	$147.00	$101.43
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	24	24	$219.33	$89.94

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	154	55	$160.00	$78.11
11042 Removal of skin and tissue, 20.0 sq cm or less	72	22	$237.00	$66.03
99213 Established patient office or other outpatient visit, typically 15 minutes	51	19	$148.04	$55.28
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	50	16	$88.00	$27.64

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
11042 Removal of skin and tissue, 20.0 sq cm or less	471	67	$237.00	$66.42
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	451	68	$88.00	$27.17
99183 Management and supervision of oxygen chamber therapy per session	201	21	$225.00	$116.21
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	171	78	$160.00	$77.41
11045 Removal of skin and tissue, each additional 20.0 sq cm or less	146	11	$100.00	$28.03
99213 Established patient office or other outpatient visit, typically 15 minutes	113	53	$147.00	$54.47
97597 Removal of tissue from wound, 20.0 sq cm or less	23	19	$200.00	$25.69
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	23	23	$218.00	$80.94

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	548	103	$88.00	$25.51
11042 Removal of skin and tissue, 20.0 sq cm or less	509	102	$237.00	$62.82
99183 Management and supervision of oxygen chamber therapy per session	221	17	$224.88	$110.03
99213 Established patient office or other outpatient visit, typically 15 minutes	188	76	$147.38	$50.78
11045 Removal of skin and tissue, each additional 20.0 sq cm or less	105	25	$94.17	$26.40
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	76	44	$223.82	$104.99
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	70	30	$154.00	$73.30
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	50	39	$276.00	$137.35
97597 Removal of tissue from wound, 20.0 sq cm or less	39	23	$185.23	$24.18
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	37	37	$218.00	$76.69
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	33	13	$481.97	$148.25
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	33	17	$88.00	$46.04
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	28	28	$267.04	$129.76
99213 Established patient office or other outpatient visit, typically 15 minutes	23	16	$147.00	$75.70
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	13	13	$218.00	$111.28

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
11042 Removal of skin and tissue, 20.0 sq cm or less	454	77	$236.48	$60.58
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	443	71	$88.00	$25.30
99183 Management and supervision of oxygen chamber therapy per session	104	11	$224.00	$109.71
99213 Established patient office or other outpatient visit, typically 15 minutes	103	41	$147.00	$47.42
11045 Removal of skin and tissue, each additional 20.0 sq cm or less	71	18	$83.00	$26.10
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	68	31	$210.00	$104.16
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	68	56	$408.00	$202.21
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	48	20	$88.00	$45.13
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	37	12	$465.00	$157.38
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	33	28	$276.00	$136.39
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	30	30	$218.00	$110.47
99213 Established patient office or other outpatient visit, typically 15 minutes	25	23	$147.00	$75.07
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	24	24	$332.00	$129.27
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	22	22	$218.00	$76.25
11044 Removal of bone, 20.0 sq cm or less	22	11	$613.77	$216.42
97597 Removal of tissue from wound, 20.0 sq cm or less	17	13	$152.00	$23.18

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License CA G44443

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

18 Associated Practitioners

Dr. Robert Boardman , MD

Specialist

NPI 1013013481

Doctor of Medicine (M.D.)

Dr. Reiko Russin , MD

Psychiatry & Neurology - Neurology

NPI 1134105331

Doctor of Medicine (M.D.)

Dr. Robert Loitz , MD

Pediatrics - Pediatric Cardiology

NPI 1225010077

Doctor of Medicine (M.D.)

Dr. Gerilynn Okamoto , DDS

Dentist

NPI 1255317954

Doctor of Dental Surgery

Dr. Elizabeth Deoliveira , MD

Pediatrics - Pediatric Cardiology

NPI 1265414833

Doctor of Medicine (M.D.)

Dr. Tommy Chen , MD

Dermatology

NPI 1326136854

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events

⚠️

NPI Profile Deactivated March 27, 2025

Record deactivated on March 27, 2025

📍

Updated Practice Location April 01, 2013

Registered at 50 BELLEFONTAINE ST, STE 303, PASADENA, CA 911053132 (Tel: 6267934136)

📍

Updated Business Mailing Address April 01, 2013

Registered at 50 BELLEFONTAINE ST, STE 303, PASADENA, CA 911053132 (Tel: 6267934136)

👤

Provider Name / Credentials Updated April 01, 2013

Recorded as THOMAS VANDER LAAN, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 01, 2013

Specialist (License #G44443 in CA)

🔄

NPI Profile Reactivated March 31, 2006

Record officially reactivated for active practice on March 31, 2006

⚠️

NPI Profile Deactivated March 17, 2006

Record deactivated on March 17, 2006

🟢

Initial NPI Registration & Enumeration June 13, 2005

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1639174063

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: June 13, 2005

Last Update: April 01, 2013

Deactivation Date: March 17, 2006

Update or Correct Profile

Mailing Address

50 Bellefontaine St, Ste 303

Pasadena, CA 911053132

Phone: 6267934136

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.