Individual provider Active NPI

Kirsten Sarah Vandenheuvel, PA-C

  • Physician Assistant
  • Fort Wayne, IN
National Provider Identifier
1477401115
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10005302A Issued in IN
Practice address
7601 W Jefferson Blvd
Fort Wayne, IN 46804-4133
Phone
(260) 436-8686
NPI assigned
Mar 18, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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 10005302A IN Primary

Addresses

Primary practice location

7601 W Jefferson Blvd
Fort Wayne, IN 46804-4133

Mailing address

7601 W Jefferson Blvd
Fort Wayne, IN 46804-4133
Phone (800) 566-5659

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
I20260522002550 IN Practitioner - Physician Assistant 9032689765 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopaedics-Indianapolis IncGroup PAC ID 7416860663, 357 clinicians

Practice addresses (Care Compare)

7601 W Jefferson Blvd
Fort Wayne, IN 46804-4133
Phone (800) 566-5659

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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.

NPI Registry JSON

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

{
    "created_epoch": "1773792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1477401115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7601 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044133",
            "telephone_number": "800-566-5659",
            "fax_number": "260-436-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044133",
            "telephone_number": "260-436-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDENHEUVEL",
        "first_name": "KIRSTEN",
        "middle_name": "SARAH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-18",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10005302A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.