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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MRS. KATHLEEN VANDERREYDEN NP
NPI 1225668312
Nurse Practitioner in Fort Wayne, IN

Active since January 17, 2020PECOS EnrolledAccepts Medicare Assignment
3030 LAKE AVE STE 24, FORT WAYNE, IN 46805(260) 201-3119(260) 233-7416 Get Directions Write a Review

NPPES record last updated: July 6, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 6, 2026, Jan 17, 2020 (2 updates tracked since 2020).

About Mrs. Kathleen Vanderreyden Np NPPES

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

MRS. KATHLEEN VANDERREYDEN NP (NPI 1225668312) is an individual nurse practitioner in Fort Wayne, Indiana, licensed in Indiana (71009667A) and active in the NPI registry since January 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1225668312
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameMRS. KATHLEEN VANDERREYDENCredential: NP
Location Address3030 LAKE AVE STE 24Fort Wayne, IN 46805-5428
Mailing Address3030 Lake Ave Ste 24Fort Wayne, IN 46805-5428 · (260) 201-3119 · Fax (260) 233-7416
Phone(260) 201-3119
Fax(260) 233-7416
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateJanuary 17, 2020
Last NPPES UpdateJuly 6, 20262 updates tracked since enumeration
NPPES CertifiedJuly 6, 2026
✔ NPI 1225668312 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in IN · 71009667A
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
3030 LAKE AVE STE 24, Fort Wayne, IN 46805
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, UnitedHealthcare.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

Mrs. Kathleen Vanderreyden Np 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 ID1557799491
PECOS Enrollment IDI20200307000064
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

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
57 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46805 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
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
Most-billed visit code 99214
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 3

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

JENNIFER LEA SCHEIDERER PT
Physical Therapist
3030 LAKE AVE STE 24
FORT WAYNE, IN 46805
Allen County (260) 424-8830
LEGACY TREATMENT CENTER LLC
Family Medicine (Addiction Medicine)
3030 LAKE AVE STE 24
FORT WAYNE, IN 46805
Allen County (260) 705-4587
MRS. LAURY FARRELL FNP
Nurse Practitioner
3030 LAKE AVE STE 24
FORT WAYNE, IN 46805
Allen County (260) 705-4587

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 Kathleen Vanderreyden's NPI number?

The NPI number for Kathleen Vanderreyden is 1225668312. It was assigned to this individual provider in the NPPES registry on January 17, 2020.

Where is Kathleen Vanderreyden located?

Kathleen Vanderreyden practices at 3030 Lake Ave Ste 24, Fort Wayne, IN 46805. The listed phone number is (260) 201-3119.

What is Kathleen Vanderreyden's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Kathleen Vanderreyden enrolled in Medicare?

Yes. Kathleen Vanderreyden 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.

What insurance does Kathleen Vanderreyden accept?

Health plans from CareSource and UnitedHealthcare list Kathleen Vanderreyden as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kathleen Vanderreyden was last updated on July 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 42 days 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.