MARY LYNN VAN VONDEREN APRN, CNP
NPI 1225280050
Nurse Practitioner in Chippewa Falls, WI
About Mary Lynn Van Vonderen Aprn, Cnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARY LYNN VAN VONDEREN APRN, CNP (NPI 1225280050) is an individual nurse practitioner in Chippewa Falls, Wisconsin, licensed in Wisconsin (3519-33) and active in the NPI registry since October 2008. She is enrolled in Medicare PECOS, maintains a secondary practice location in Hayward, and is a graduate of Other (2009).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mary Lynn Van Vonderen Aprn, Cnp 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.
Medicare Billing Reassignments
2Medicare enrollment records show Mary Van Vonderen reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Hayward, WI 54843
- Reassigned Medicare billing, Wisconsin enrollment
- Medicare enrollment name: Lac Courte Oreilles Governing Board
- 26 clinicians in this Medicare group
Hayward, WI 54843
- Reassigned Medicare billing, Wisconsin enrollment
- 104 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 54729 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
CHIPPEWA FALLS, WI 54729
CHIPPEWA FALLS, WI 54729
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mary Van Vonderen's NPI number?
The NPI number for Mary Van Vonderen is 1225280050. It was assigned to this individual provider in the NPPES registry on October 10, 2008.
Where is Mary Van Vonderen located?
Mary Van Vonderen practices at 2509 County Highway I, Chippewa Falls, WI 54729. The listed phone number is (920) 496-4700.
What is Mary Van Vonderen's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Mary Van Vonderen enrolled in Medicare?
Yes. Mary Van Vonderen is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Mary Van Vonderen's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mary Van Vonderen reassigns Medicare benefits to 2 organizations: Lac Courte Oreilles Governing (Hayward, WI) and Medical Services, Inc (Hayward, WI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mary Van Vonderen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Mary Van Vonderen was last updated on March 14, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.
# Mary Lynn Van Vonderen, APRN, CNP · NPI 1225280050
Nurse Practitioner physician in Chippewa Falls, Wisconsin. Individual provider, active in the CMS NPPES registry since October 10, 2008.
## Identity
- **NPI:** 1225280050 (Entity type: Individual)
- **Enumerated:** October 10, 2008
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** 3519-33 (Wisconsin)
- **Sole proprietor:** No
## Practice location
- **Address:** 2509 COUNTY HIGHWAY I, Chippewa Falls, WI 54729-2785
- **Phone:** (920) 496-4700
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Lac Courte Oreilles Governing (NPI 1194830208, Hayward, WI); Medical Services, Inc (NPI 1912992827, Hayward, WI) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2009
## Record status
- **NPPES last updated:** March 14, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1225280050) · Data from the CMS NPPES public registry.