CYNTHIA L. VANDERBOSCH (M.D.) – Family Medicine Physician, NPI 1235120544
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for CYNTHIA L. VANDERBOSCH (M.D.)
3534, Brooklyn Avenue, Indian Village, Fort Wayne, Allen County, Indiana, 46809, United States
FORT WAYNE, IN 468091361
Phone: (260) 747-6171
Fax: (260) 478-5125
Type: Mailing
2516, East Dupont Road, Fort Wayne, Allen County, Indiana, 46825, United States
FORT WAYNE, IN 468251608
Phone: (260) 471-7622
Fax: (260) 489-5469
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2007-06-22
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 |
|---|---|---|---|---|
| I20070622000396 | I | Family Practice | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 19 | 17 | $0 |
Insurance plans in this area (ZIP 46809)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | IN | 81002 | Urinalysis, manual test | 19 | 19 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IN | |
| Family Practice | IN | |
| Clinical Psychologist | IN | |
| Family Practice | IN | |
| - | IN | |
| Family Practice | IN | |
| - | IN | |
| Family Practice, Emergency Medicine | IN | |
| - | IN | |
| - | IN |
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