KIMBERLY ANN VONDERLIETH PA
NPI 1396917522
Physician Assistant - Surgical in Melbourne, FL

Q: What is Kimberly Vonderlieth's NPI number?

The NPI number for Kimberly Vonderlieth is 1396917522. It was assigned to this individual provider in the NPPES registry on March 27, 2008.

Q: What is Kimberly Vonderlieth's specialty?

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

Active since March 27, 2008PECOS EnrolledAccepts Medicare Assignment

85.38/100

CMS Quality Rating

1251 HICKORY ST, MELBOURNE, FL 32901(321) 434-3420(321) 434-3423 Get Directions Write a Review

NPPES record last updated: November 17, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Nov 17, 2025, Mar 16, 2020, Mar 11, 2020 and 3 more (6 updates tracked since 2019).

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About Kimberly Ann Vonderlieth Pa NPPES

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

KIMBERLY ANN VONDERLIETH PA (NPI 1396917522) is an individual surgical provider in Melbourne, Florida, licensed in Florida (PA9101648) and active in the NPI registry since March 2008. She is enrolled in Medicare PECOS, is affiliated with Holmes Regional Medical Center, and maintains a secondary practice location in Melbourne.

NPPES Registry Identity

NPI1396917522

Entity TypeIndividualFemale

Primary Taxonomy363AS0400X

Provider Legal NameKIMBERLY ANN VONDERLIETHCredential: PA

Location Address1251 HICKORY STMelbourne, FL 32901-3221

Mailing Address3300 S Fiske BlvdRockledge, FL 32955-4306 · (321) 434-3420

Phone(321) 434-3420

Fax(321) 434-3423

Sole ProprietorYes

Medical School CMSOtherGraduated 1993

Enumeration DateMarch 27, 2008

Last NPPES UpdateNovember 17, 20256 updates tracked since enumeration

NPPES CertifiedNovember 17, 2025

✔ NPI 1396917522 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 FL · PA9101648

Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License PA9101648 (FL)

1251 HICKORY ST, Melbourne, FL 32901

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Secondary Practice Location 1

Location 11350 Hickory StMelbourne, FL 32901-3224 · Phone (321) 434-3420 · Fax (321) 434-3423

Other Identifiers 3

OtherLS853FL · Fl Medicare

Medicaid104257000FL

OtherLY388FL · Fl Medicare

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

Kimberly Ann Vonderlieth Pa 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 ID9739083627

PECOS Enrollment IDI20031121000700

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 4

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 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.

184 services138 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.

80 services76 patients

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.

62 services58 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

25 services25 patients

Hospital Affiliations CMS Care Compare 4

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

Holmes Regional Medical Center

Acute Care Hospitals · Melbourne, FL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100019

Location1350 S Hickory StMelbourne, FL 32901 · Brevard County

Emergency services Birthing friendly

Cape Canaveral Hospital

Acute Care Hospitals · Cocoa Beach, FL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100177

Location701 W Cocoa Beach CausewayCocoa Beach, FL 32932 · Brevard County

Emergency services Birthing friendly

Viera Hospital

Acute Care Hospitals · Melbourne, FL

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100315

Location8745 N Wickham RdMelbourne, FL 32940 · Brevard County

Emergency services

Palm Bay Hospital

Acute Care Hospitals · Palm Bay, FL

4/5 CMS rating

OwnershipProprietary

CMS Certification Number100316

Location1425 Malabar Rd, NEPalm Bay, FL 32907 · Brevard County

Emergency services

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

85.38/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

81.65

Promoting Interoperability

Improvement Activities

Other Providers at the Same Location NPPES 8

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

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