Mrs Kathleen Vanderreyden, NP in Fort Wayne, IN

Mrs Kathleen Vanderreyden, NP is a medicare enrolled "Nurse Practitioner" in Fort Wayne, Indiana. She graduated from nursing school in 2019 and has 6 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Chicagoland Infectious Disease Pc and her current practice location is 3030 Lake Ave Ste 24, Fort Wayne, Indiana. You can reach out to her office (for appointments etc.) via phone at (260) 201-3119.

Mrs Kathleen Vanderreyden is licensed to practice in Indiana (license number 7100966A) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1225668312.

Contact Information

	Mrs Kathleen Vanderreyden, NP
	3030 Lake Ave Ste 24, Fort Wayne, IN 46805-5428
	(260) 201-3119
	(260) 233-7416

Map and Direction

Provider's Profile

Full Name	Mrs Kathleen Vanderreyden
Gender	Female
Speciality	Nurse Practitioner
Experience	6 Years
Location	3030 Lake Ave Ste 24, Fort Wayne, Indiana
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mrs Kathleen Vanderreyden graduated from nursing school in 2019

NPI Data:

NPI Number: 1225668312
Provider Enumeration Date: 01/17/2020
Last Update Date: 10/23/2025

Medicare PECOS Information:

PECOS PAC ID: 1557799491
Enrollment ID: I20200307000064

Medical Identifiers

Medical identifiers for Mrs Kathleen Vanderreyden such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1225668312	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	7100966A (Indiana)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Chicagoland Infectious Disease Pc	5193948362	36

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Kathleen Vanderreyden allows following entities to bill medicare on her behalf.

Entity Name	Chicagoland Infectious Disease Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1780002352 PECOS PAC ID: 5193948362 Enrollment ID: O20150205000149

Entity Name	Cleanslate Medical Group Of Indiana Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1023464294 PECOS PAC ID: 4880963909 Enrollment ID: O20171023001515

Entity Name	Fort Wayne Primary Care Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1528707619 PECOS PAC ID: 6608258116 Enrollment ID: O20220801000488

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Kathleen Vanderreyden is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mrs Kathleen Vanderreyden, NP 3030 Lake Ave Ste 24, Fort Wayne, IN 46805-5428 Ph: (260) 201-3119	Mrs Kathleen Vanderreyden, NP 3030 Lake Ave Ste 24, Fort Wayne, IN 46805-5428 Ph: (260) 201-3119

Reviews and Comments

Nurse Practitioner Nurses in Fort Wayne, IN

Carrie Jean Boots, N.P. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 7910 W Jefferson Blvd Ste 108, Fort Wayne, IN 46804 Phone: 260-484-8830 Fax: 260-483-1911
Mrs. Jamie Lynn Peppler, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5910 Homestead Rd, Fort Wayne, IN 46814 Phone: 260-435-3272 Fax: 260-435-3275
Luann Deafenbaugh, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 7910 W Jefferson Blvd Ste 108, Fort Wayne, IN 46804 Phone: 260-436-0800 Fax: 260-483-1911
Stephanie Ann Clouse, NP-C Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 7910 W Jefferson Blvd Ste 120, Fort Wayne, IN 46804 Phone: 260-435-7612 Fax: 260-435-7672
Mr. Justin Michael Garrison, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4008 Stanton Dr, Fort Wayne, IN 46815 Phone: 260-760-7753
Cathy S Walker, FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1234 E. Dupont Rd., Suite 6, Fort Wayne, IN 46825 Phone: 260-480-2600 Fax: 260-496-8077
Cara E Walker, APN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 11123 Parkview Plaza Dr, Suite 101, Fort Wayne, IN 46845 Phone: 260-422-7455

Mrs Kathleen Vanderreyden, NP - Medicare Nurse Practitioner in Fort Wayne, IN