Cynthia L. Vanderbosch, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01037767A Issued in IN

Practice address

2516 E Dupont Rd
Fort Wayne, IN 46825-1608

Phone

(260) 471-7622

Fax

(260) 489-5469

NPI assigned

Nov 4, 2005

Last updated

Mar 4, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

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

Merit-based Incentive Payment System (MIPS)

Final score

97.04 of 100Reported as group

Quality

79.76

Promoting interoperability

94

Improvement activities

40

Cost

85.08

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cynthia.vanderbosch@nhci.eclinicaldirectplus.com

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

• Indiana University Health Ball Memorial Physicians, Inc.

  • Family Medicine Physician
  • Muncie, IN
  • NPI 1235455544
  Medicare reassignment NPD
• Neighborhood Health Clinics, Inc

  • Clinic/Center
  • Fort Wayne, IN
  • NPI 1548291222
  Medicare reassignment
• Indiana University Health Fort Wayne Physicians, LLC

  • Family Medicine Physician
  • Muncie, IN
  • NPI 1316550445
  NPD
• Brooklyn Medical Associates, PC

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1851512198
  NPD (past)

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362355200000",
    "number": "1235120544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3534 BROOKLYN AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468091361",
            "telephone_number": "260-747-6171",
            "fax_number": "260-478-5125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2516 E DUPONT RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251608",
            "telephone_number": "260-471-7622",
            "fax_number": "260-489-5469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERBOSCH",
        "first_name": "CYNTHIA",
        "middle_name": "L.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-04",
        "last_updated": "2013-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01037767A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100369350",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000000091894",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIANS HEALTH PLAN",
            "identifier": "1975",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080122015",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MPLAN",
            "identifier": "000000000312",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lynn Vandame, PAC
• Megan Vandell, PMHNP
• Frederick Noel Vandeman, MD
• Kirsten Sarah Vandenheuvel, PA-C
• Heather L Vandentop
• Trever Vanderhorst, MD
• Craig William Vandermaden, PTA
• Emily Nicole Vandermaden, DPT
• Kathleen Vanderreyden, NP
• Robin Gene Vandeventer

• Family Medicine Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.