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KELLY RAE VANDERMUSS PA-C
NPI 1760042923
Physician Assistant in De Pere, WI

Active since June 19, 2019PECOS EnrolledAccepts Medicare Assignment
94.61/100
CMS Quality Rating
1381 BRAYDEN LN, DE PERE, WI 54115(920) 664-3734 Get Directions Write a Review

NPPES record last updated: December 5, 2019. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Dec 5, 2019, Jun 19, 2019 (2 updates tracked since 2019).

About Kelly Rae Vandermuss Pa-c NPPES

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

KELLY RAE VANDERMUSS PA-C (NPI 1760042923) is an individual physician assistant in De Pere, Wisconsin, licensed in Wisconsin (4704-23) and active in the NPI registry since June 2019. She is enrolled in Medicare PECOS, is affiliated with St Vincent Hospital, and is a graduate of Other (2009).

NPPES Registry Identity

NPI1760042923
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameKELLY RAE VANDERMUSSCredential: PA-C
Location Address1381 BRAYDEN LNDe Pere, WI 54115-9249
Mailing Address2502 S Ashland AveGreen Bay, WI 54304-5252 · (920) 496-4700
Phone(920) 664-3734
Sole ProprietorNo
Medical School CMSOtherGraduated 2009
Enumeration DateJune 19, 2019
Last NPPES UpdateDecember 5, 20192 updates tracked since enumeration
✔ NPI 1760042923 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in WI · 4704-23
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.
1381 BRAYDEN LN, De Pere, WI 54115
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Other Names 1

Former Name (1)Kelly Rae Marble

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Network Health.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

Kelly Rae Vandermuss 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 ID7618202763
PECOS Enrollment IDI20190711000451
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 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.
22 services16 patients

Hospital Affiliations CMS Care Compare

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

St Vincent Hospital

Acute Care Hospitals · Green Bay, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number520075
Location835 S Van Buren StGreen Bay, WI 54301 · Brown County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54115 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
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.

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.

94.61/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.17
Promoting Interoperability100
Improvement Activities40

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 Kelly Vandermuss's NPI number?

The NPI number for Kelly Vandermuss is 1760042923. It was assigned to this individual provider in the NPPES registry on June 19, 2019. The provider is also known as Kelly Rae Marble.

Where is Kelly Vandermuss located?

Kelly Vandermuss practices at 1381 Brayden Ln, De Pere, WI 54115. The listed phone number is (920) 664-3734.

What is Kelly Vandermuss's specialty?

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

Is Kelly Vandermuss enrolled in Medicare?

Yes. Kelly Vandermuss 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 Kelly Vandermuss accept?

Health plans from Anthem Blue Cross and Blue Shield and Network Health list Kelly Vandermuss 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.

Is Kelly Vandermuss affiliated with any hospitals?

According to CMS data, Kelly Vandermuss is affiliated with St Vincent Hospital.

When was this NPI record last updated?

The NPPES record for Kelly Vandermuss was last updated on December 5, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.