KEVIN VANDOKKUMBURG PA-C
NPI 1134514490
Physician Assistant - Surgical in Grand Rapids, MI

Q: What is Kevin Vandokkumburg's NPI number?

The NPI number for Kevin Vandokkumburg is 1134514490. It was assigned to this individual provider in the NPPES registry on April 3, 2015.

Q: What is Kevin Vandokkumburg's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Active since April 03, 2015PECOS EnrolledAccepts Medicare Assignment

2144 E PARIS AVE SE STE 240, GRAND RAPIDS, MI 49546(616) 949-8945(616) 949-1115 Get Directions Write a Review

NPPES record last updated: June 12, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 12, 2023, Oct 6, 2021 (2 updates tracked since 2021).

On this page

About Kevin Vandokkumburg Pa-c NPPES

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

KEVIN VANDOKKUMBURG PA-C (NPI 1134514490) is an individual surgical provider in Grand Rapids, Michigan, licensed in Michigan (5601007350) and active in the NPI registry since April 2015. He is enrolled in Medicare PECOS, is affiliated with Spectrum Health, and is a graduate of Rush Medical College Of Rush University (2015).

NPPES Registry Identity

NPI1134514490

Entity TypeIndividualMale

Primary Taxonomy363AS0400X

Provider Legal NameKEVIN VANDOKKUMBURGCredential: PA-C

Location Address2144 E PARIS AVE SE STE 240Grand Rapids, MI 49546-6117

Mailing Address2144 E Paris Ave Se Ste 240Grand Rapids, MI 49546-6117 · (616) 949-8945 · Fax (616) 949-1115

Phone(616) 949-8945

Fax(616) 949-1115

Sole ProprietorNo

Medical School CMSRush Medical College Of Rush UniversityGraduated 2015

Enumeration DateApril 3, 2015

Last NPPES UpdateJune 12, 20232 updates tracked since enumeration

NPPES CertifiedJune 12, 2023

✔ NPI 1134514490 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in MI · 5601007350

Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License 5601007350 (MI)

2144 E PARIS AVE SE STE 240, Grand Rapids, MI 49546

Open in Google Maps ↗

Other Identifiers 1

Medicaid1134514490MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kevin Vandokkumburg Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1456670231

PECOS Enrollment IDI20150428002141

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.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

87 services28 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

65 services33 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

45 services36 patients

Injection, methylprednisolone acetate, 80 mg J1040

Methylprednisolone acetate is a strong anti-inflammatory medication. It is often given as an 80 mg injection to reduce inflammation and pain. It's commonly used for conditions like arthritis, allergic disorders, or other inflammatory diseases.

30 services21 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

25 services22 patients

Replacement of thigh bone and hip joint with prosthesis 27130

This procedure, known as hip arthroplasty, involves replacing your damaged thigh bone and hip joint with artificial parts, called a prosthesis. It helps relieve pain, improve mobility, and enhance your quality of life.

23 services23 patients

Hospital Affiliations CMS Care Compare

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

Spectrum Health

Acute Care Hospitals · Grand Rapids, MI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230038

Location100 Michigan St NEGrand Rapids, MI 49503 · Kent County

Emergency services Birthing friendly

Other Providers at the Same Location NPPES 5

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

CARL WIERKS M.D.

Orthopaedic Surgery (Sports Medicine)