Individual provider Active NPI

Kyle Jon Van Arendonk, M.D.

  • Pediatric Surgery Physician
  • Milwaukee, WI
National Provider Identifier
1659544211
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
69327-20 Issued in WI
Practice address
9000 W Wisconsin Ave
Milwaukee, WI 53226-4874
Phone
(414) 266-6550
Fax
(414) 266-6579
NPI assigned
Apr 3, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X 35.149179 OH
Pediatric Surgery Physician 2086S0120X 69327-20 WI Primary

Addresses

Primary practice location

9000 W Wisconsin Ave
Milwaukee, WI 53226-4874

Mailing address

9000 W Wisconsin Ave
Milwaukee, WI 53226-4874
Phone (414) 266-6550

Other practice location 1

5665 Venture Dr
Dublin, OH 43017-2159
Phone (614) 722-2000

Other practice location 2

999 N 92nd St Ste 320
Milwaukee, WI 53226
Phone (414) 266-6550

Other practice location 3

700 Childrens Dr
Columbus, OH 43205-2664
Phone (614) 722-2000

Other practice location 4

455 Executive Campus Dr
Westerville, OH 43082-8870
Phone (614) 722-2000

Other practice location 5

536 S Trimble Rd
Mansfield, OH 44906-3418
Phone (614) 722-2000

Other practice location 6

1655 W Mequon Rd
Mequon, WI 53092-3254
Phone (414) 266-6550

Other practice location 7

4855 S Moorland Rd
New Berlin, WI 53151-7494
Phone (414) 266-6550

Other practice location 8

555 S 18th St
Columbus, OH 43205-2654
Phone (614) 722-2000

Other practice location 9

3195 Hillside Dr
Delafield, WI 53018-2189
Phone (414) 266-6550

Other practice location 10

26 Hospital Dr
Athens, OH 45701-2471
Phone (614) 722-2000

Other identifiers 3

IdentifierTypeStateIssuer
1659544211MedicaidWI
H0007327OtherOHCGS - MEDICARE
0027771MedicaidOH

Other names 1

  • Kyle J Vanarendonk Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20230913001906 OH Practitioner - General SurgeryPractitioner - Pediatric Medicine 6800083775 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.149179OHMDPediatric Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nationwide Children'S Hospital CurrentSince Sep 24, 2024 Accepting new patients
Nationwide Children'S Hospital CurrentSince Sep 24, 2024 Accepting new patients
Children'S Surgical Associates, Corporation Pediatric Surgery CurrentSince Oct 16, 2023 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Nationwide Children'S Hospital Past Accepting new patients
The Medical College of Wisconsin Inc Past Accepting new patients
Nationwide Children'S Hospital Past Accepting new patients

Locations

Dept 781629
Detroit, MI 48278

26 Hospital Dr
Athens, OH 45701
Phone (614) 722-2530

555 S 18th St
Columbus, OH 43205
Phone (614) 722-4554

700 Childrens Dr
Columbus, OH 43205
Phone (614) 722-4411

405 Butterfly Gardens Dr
Columbus, OH 43215
Phone (614) 722-4200

1 Childrens Plz
Dayton, OH 45404
Phone (937) 641-3600

5665 Venture Dr
Dublin, OH 43017
Phone (614) 355-8480

536 S Trimble Rd
Mansfield, OH 44906
Phone (419) 528-3150

455 Executive Campus Dr
Westerville, OH 43082
Phone (614) 355-6100

Interoperability endpoints

  • Direct secure messaging: kyle.vanarendonk@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 7

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": "1207180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1659544211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-6550",
            "fax_number": "414-266-6579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-6550",
            "fax_number": "414-266-6579"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5665 Venture Dr",
            "address_purpose": "LOCATION",
            "city": "Dublin",
            "state": "OH",
            "postal_code": "430172159",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "999 N 92nd St Ste 320",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "53226",
            "country_code": "US",
            "telephone_number": "414-266-6550",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 Childrens Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432052664",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "455 Executive Campus Dr",
            "address_purpose": "LOCATION",
            "city": "Westerville",
            "state": "OH",
            "postal_code": "430828870",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "536 S Trimble Rd",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "OH",
            "postal_code": "449063418",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1655 W Mequon Rd",
            "address_purpose": "LOCATION",
            "city": "Mequon",
            "state": "WI",
            "postal_code": "530923254",
            "country_code": "US",
            "telephone_number": "414-266-6550",
            "fax_number": "414-266-6579",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4855 S Moorland Rd",
            "address_purpose": "LOCATION",
            "city": "New Berlin",
            "state": "WI",
            "postal_code": "531517494",
            "country_code": "US",
            "telephone_number": "414-266-6550",
            "fax_number": "414-266-6579",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "555 S 18th St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432052654",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3195 Hillside Dr",
            "address_purpose": "LOCATION",
            "city": "Delafield",
            "state": "WI",
            "postal_code": "530182189",
            "country_code": "US",
            "telephone_number": "414-266-6550",
            "fax_number": "414-266-6579",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "26 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "OH",
            "postal_code": "457012471",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN ARENDONK",
        "first_name": "KYLE",
        "middle_name": "JON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-03",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "OH",
            "license": "35.149179",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "WI",
            "license": "69327-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659544211",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CGS - MEDICARE",
            "identifier": "H0007327",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0027771",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYLE",
            "last_name": "VANARENDONK",
            "middle_name": "J",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.