KAYLA RENE VANDERWALL (PA-C) – Surgical Physician Assistant, NPI 1164840922
Surgical Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
Provider Addresses for KAYLA RENE VANDERWALL (PA-C)
1200 S YORK ST STE 3280
ELMHURST, IL 601265638
Phone: (630) 646-6020
Type: Mailing
231 Noordewier Hall
Grand Rapids, MI 495464417
Phone: (219) 743-9368
Type: Location
1200 S York St Ste 3280
Elmhurst, IL 601265638
Phone: (630) 646-6020
Type: Location
7979 N Shadeland Ave Ste 310
Indianapolis, IN 462502042
Phone: (317) 621-0668
Type: Location
7430 N SHADELAND AVE STE 200
INDIANAPOLIS, IN 462502036
Phone: (317) 621-0668
Type: Location
6626 E 75TH ST STE 500
INDIANAPOLIS, IN 462502890
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 41 Open Payments records for all available years, with a total value of $944.
Total Amount is formed as General ($944) + Research ($0) + Ownership ($0) = $944.
Last reported payment date: 2024-12-16 • Largest payer in this snapshot: ABBVIE INC. ($497).
Total Amount
$944
General + Research + Ownership
Payments
41
Total payment records
General Amount
$944
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $497 |
| Axonics, Inc. | $121 |
| Takeda Pharmaceuticals U.S.A., Inc. | $117 |
| Janssen Biotech, Inc. | $61 |
| Kerecis Limited | $43 |
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: 2022-08-10
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
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 |
|---|---|---|---|---|
| I20220810002156 | I | Physician Assistant | IN | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 66 | 54 | $0 |
| 46600 | Diagnostic exam of anus using an endoscope | 27 | 23 | $0 |
Insurance plans in this area (ZIP 60126)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Cardiac Electrophysiology | NV | |
| Family Practice | IN | |
| - | IN | |
| - | IN | |
| Physician Assistant | IN | |
| Geriatric Medicine | IN | |
| Family Practice | IN | |
| - | IN | |
| Nurse Practitioner | IN | |
| Nurse Practitioner | IN |
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