Individual provider Active NPI

Victoria A. Vamos, PA-C

  • Physician Assistant
  • Fort Wayne, IN
National Provider Identifier
1083311435
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10003954A Issued in IN
Practice address
7900 W Jefferson Blvd Ste 306
Fort Wayne, IN 46804-4128
Phone
(260) 458-3610
Fax
(260) 458-3611
NPI assigned
Feb 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10003954A IN Primary

Addresses

Primary practice location

7900 W Jefferson Blvd Ste 306
Fort Wayne, IN 46804-4128

Mailing address

6920 Pointe Inverness Way Ste 200
Fort Wayne, IN 46804-7934
Phone (260) 479-3514

Other practice location 1

801 MacArthur Blvd Ste 305
Munster, IN 46321-2920
Phone (219) 703-2401

Other identifiers 1

IdentifierTypeStateIssuer
300073301MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230330001528 IN Practitioner - Physician Assistant 5890169072 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Network IncGroup PAC ID 3678737012, 378 clinicians

Practice addresses (Care Compare)

1400 S Lake Park Ave
Hobart, IN 46342-6791

1500 S Lake Park Ave
Hobart, IN 46342-6638

4321 Fir St
East Chicago, IN 46312-3049
Phone (219) 392-7005

801 Macarthur Blvd
Munster, IN 46321-2920

901 Macarthur Blvd
Munster, IN 46321-2901
Phone (219) 836-4563

9130 Columbia Ave
Munster, IN 46321-2932

Hospital & facility affiliations

  • Community Hospital Hospital, Munster, IN, CCN 150125
  • St Mary Medical Center Inc Hospital, Hobart, IN, CCN 150034
  • St Catherine Hospital Inc Hospital, East Chicago, IN, CCN 150008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Network Inc Physician Assistant CurrentSince Dec 1, 2023 Accepting new patients

Locations

4321 Fir St
East Chicago, IN 46312
Phone (219) 392-1700

1400 S Lake Park Ave
Ste 300
Hobart, IN 46342
Phone (219) 942-1169

9104 Columbia Ave
Munster, IN 46321
Phone (219) 836-4473

9120 Columbia Ave
Munster, IN 46321
Phone (219) 513-9415

801 MacArthur Blvd
Ste 305
Munster, IN 46321
Phone (219) 703-2401

9130 Columbia Ave
Ste A
Munster, IN 46321
Phone (219) 365-1166

Interoperability endpoints

  • Direct secure messaging: vvamos159561@ssdirect.comhs.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1676419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1083311435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6920 POINTE INVERNESS WAY STE 200",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047934",
            "telephone_number": "260-479-3514",
            "fax_number": "260-479-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 W JEFFERSON BLVD STE 306",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044128",
            "telephone_number": "260-458-3610",
            "fax_number": "260-458-3611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 MacArthur Blvd Ste 305",
            "address_purpose": "LOCATION",
            "city": "Munster",
            "state": "IN",
            "postal_code": "463212920",
            "country_code": "US",
            "telephone_number": "219-703-2401",
            "fax_number": "219-703-6687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAMOS",
        "first_name": "VICTORIA",
        "middle_name": "A.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-15",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003954A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300073301",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.