Individual provider Active NPI

Trever Vanderhorst, MD

  • Family Medicine Physician
  • Fort Wayne, IN
National Provider Identifier
1144635145
Registry record updated Oct 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11017699A Issued in IN
Practice address
5693 YMCA Park Dr W
Fort Wayne, IN 46835-3280
Phone
(260) 469-6603
Fax
(260) 486-6123
NPI assigned
Jun 27, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11017699A IN Primary

Addresses

Primary practice location

5693 YMCA Park Dr W
Fort Wayne, IN 46835-3280

Mailing address

11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address tvanderhorst75481@Direct.Parkviewexchange.com
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151113002185 IN Practitioner - Family Practice 9537389275 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Parkview Health System IncGroup PAC ID 2163336967, 1,350 clinicians

Practice addresses (Care Compare)

3909 New Vision Dr
PPG First Care Walk in Clinic
Fort Wayne, IN 46845-1725
Phone (260) 469-6610

Hospital & facility affiliations

  • Heartland Home Health (Fort Wayne) Home health agency, Fort Wayne, IN, CCN 157205
  • Parkview Health at Home LLC Home health agency, Fort Wayne, IN, CCN 157423
  • Parkview Regional Medical Center Hospital, Fort Wayne, IN, CCN 150021

Merit-based Incentive Payment System (MIPS)

Final score
83.53 of 100Reported as group
Quality
70
Promoting interoperability
100
Improvement activities
40
Cost
75.11

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Health System Inc Family Medicine CurrentSince Aug 14, 2017 Accepting new patients

Locations

817 Trail Ridge Rd
Albion, IN 46701
Phone (260) 373-9590

1381 N Wayne St
Angola, IN 46703
Phone (219) 481-4700

306 E Maumee St
Angola, IN 46703
Phone (260) 667-5335

416 E Maumee St
Angola, IN 46703
Phone (260) 665-2141

11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012

5693 Ymca Park Dr W
Fort Wayne, IN 46835
Phone (260) 425-6500

3926 New Vision Dr
Fort Wayne, IN 46845
Phone (260) 266-8210

3909 New Vision Dr
Fort Wayne, IN 46845
Phone (260) 373-8000

240 S Jefferson St
Ste B
Huntington, IN 46750
Phone (219) 259-0000

Interoperability endpoints

  • Direct secure messaging: tvanderhorst75481@direct.parkviewexchange.com

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 3

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": "1403827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1144635145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5693 YMCA PARK DR W",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468353280",
            "telephone_number": "260-469-6603",
            "fax_number": "260-486-6123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERHORST",
        "first_name": "TREVER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-27",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "11017699A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tvanderhorst75481@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "5693 YMCA Park Dr W",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468353280",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "5693 YMCA Park Dr W",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468353280",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "5693 YMCA Park Dr W",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468353280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.