NPIMap

Individual provider Active NPI

Kevin Marinus Vanden Berge, MD

  • Orthopaedic Surgery Physician
  • Stephenville, TX
National Provider Identifier
1760695449
Registry record updated Mar 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
N2329 Issued in TX
Practice address
351 E Tarleton St
Stephenville, TX 76401-3511
Phone
(254) 968-0292
Fax
(888) 289-1607
NPI assigned
May 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X AP 2247799-54061 TX
Orthopaedic Surgery Physician 207X00000X N2329 TX Primary

Addresses

Primary practice location

351 E Tarleton St
Stephenville, TX 76401-3511

Mailing address

PO Box 2576
Stephenville, TX 76401-0043
Phone (254) 968-0292

Other identifiers 2

IdentifierTypeStateIssuer
8CU164OtherBLUE CROSS
281982301MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110629000090 TX Practitioner - Orthopedic Surgery 0244418952 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Texas Tech University Health Science Center School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
VB Orthopaedics, PAGroup PAC ID 8921235516, 3 clinicians

Practice addresses (Care Compare)

1021 Holden St
Glen Rose, TX 76043-4937
Phone (254) 879-2215

351 E Tarleton St
Stephenville, TX 76401-3511
Phone (254) 968-0292

411 N Belknap St
Stephenville, TX 76401-3415
Phone (254) 965-1500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.98 of 100Reported as group
Quality
95
Improvement activities
40
Cost
49.93

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement28
Knee replacement68
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)13
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N2329TXMDOrthopaedic Surgery Physician
AP 2247799-54061TXMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
VB Orthopaedics PA Orthopaedic Surgery CurrentSince Nov 1, 2013 Accepting new patients
Cross Timbers Imaging Past Accepting new patients

Locations

351 E Tarleton St
Stephenville, TX 76401
Phone (254) 968-0292

411 N Belknap St
Stephenville, TX 76401
Phone (254) 965-1500

Organizations & group practices 2

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 9

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": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553817600000",
    "number": "1760695449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2576",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764010043",
            "telephone_number": "254-968-0292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 E TARLETON ST",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764013511",
            "telephone_number": "254-968-0292",
            "fax_number": "888-289-1607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDEN BERGE",
        "first_name": "KEVIN",
        "middle_name": "MARINUS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2019-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "AP 2247799-54061",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "N2329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "8CU164",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "281982301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stephenville, TX

Sources for this page

Verify at the official NPI Registry.