DR. MICHELLE H VANDENBOSCH (MD) – Family Medicine Physician, NPI 1023205051
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
6,722 FAMILY PRACTICE in FL
Provider Addresses for DR. MICHELLE H VANDENBOSCH (MD)
1200 Henley Ln
Baker, FL 325312702
Phone: (850) 537-9312
Fax: (850) 537-9319
Type: Location
5808B Highway 189 N
Baker, FL 325312506
Phone: (850) 669-9023
Fax: (850) 669-9024
Type: Location
5808B HIGHWAY 189 N
BAKER, FL 325312506
Phone: (850) 669-9023
Fax: (850) 669-9024
Type: Location
Wedgewood Lane, Crestview, Okaloosa County, Florida, 32536, United States
CRESTVIEW, FL 325361503
Phone: (850) 398-5408
Fax: (850) 398-5408
Type: Mailing
PO BOX 35380
LAS VEGAS, NV 891335380
Phone: (702) 877-5199
Type: Mailing
4835 S DURANGO DR
LAS VEGAS, NV 891478171
Phone: (702) 877-5199
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $17.
Total Amount is formed as General ($17) + Research ($0) + Ownership ($0) = $17.
Last reported payment date: 2023-11-08 • Largest payer in this snapshot: Lilly USA, LLC ($17).
Total Amount
$17
General + Research + Ownership
Payments
1
Total payment records
General Amount
$17
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-11-08
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lilly USA, LLC | $17 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-10-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20031204001140 | I | Emergency Medicine | FL | TBD |
| I20241016000405 | I | Family Practice | NV | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32531)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | TX | |
| Internal Medicine | NV | |
| Physician Assistant | NV | |
| - | KY | |
| Nurse Practitioner | NV | |
| - | NV | |
| Nurse Practitioner | NV | |
| O B S T E T R I C S/ G Y N E C O L O G Y | NV | |
| Nurse Practitioner | IL | |
| - | NV |
Reviews
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