SAMANTHA VONDERAU PA
NPI 1124999321
Physician Assistant in Fort Wayne, IN

Q: What is Samantha Vonderau's NPI number?

The NPI number for Samantha Vonderau is 1124999321. It was assigned to this individual provider in the NPPES registry on September 12, 2025.

Q: What is Samantha Vonderau's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Samantha Vonderau was last updated on November 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 12, 2025PECOS Enrolled

7201 ENGLE RD, FORT WAYNE, IN 46804(260) 432-1800(260) 432-1804 Get Directions Write a Review

NPPES record last updated: November 12, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 12, 2025, Sep 12, 2025 (2 updates tracked since 2025).

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About Samantha Vonderau Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMANTHA VONDERAU PA (NPI 1124999321) is an individual physician assistant in Fort Wayne, Indiana and active in the NPI registry since September 2025. She is enrolled in Medicare PECOS, is affiliated with Parkview Regional Medical Center, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1124999321

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameSAMANTHA VONDERAUCredential: PA

Location Address7201 ENGLE RDFort Wayne, IN 46804-2228

Mailing Address7201 Engle RdFort Wayne, IN 46804-2228 · (260) 432-1800 · Fax (260) 432-1804

Phone(260) 432-1800

Fax(260) 432-1804

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateSeptember 12, 2025

Last NPPES UpdateNovember 12, 20252 updates tracked since enumeration

NPPES CertifiedNovember 12, 2025

✔ NPI 1124999321 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

7201 ENGLE RD, Fort Wayne, IN 46804

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samantha Vonderau Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2668964255

PECOS Enrollment IDI20251121000508

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Parkview Regional Medical Center

Acute Care Hospitals · Fort Wayne, IN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150021

Location11109 Parkview Plaza DriveFort Wayne, IN 46845 · Allen County

Emergency services Birthing friendly

Bluffton Regional Medical Center

Acute Care Hospitals · Bluffton, IN

4/5 CMS rating

OwnershipProprietary

CMS Certification Number150075

Location303 S Main StBluffton, IN 46714 · Wells County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46804 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.04 typical visit price

range $53.07 – $161.76

Typical copayment $20.51 (range $13.26 – $40.44)

Most-billed visit code 99203

Established Patient

$66.48 typical visit price

range $16.93 – $132.22

Typical copayment $16.62 (range $4.23 – $33.05)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DAVID S STENSLAND M.D.

Physical Medicine & Rehabilitation