PAMELA VANDERMARK (NP) – Gerontology Nurse Practitioner, NPI 1740557610
Gerontology Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,191 NURSE PRACTITIONER in IN
Provider Addresses for PAMELA VANDERMARK (NP)
3834 S Emerson Ave
Building C, Suite 100
Indianapolis, IN 46203
Phone: (317) 782-1577
Fax: (317) 780-5538
Type: Location
30 W RAMPART ST STE 200
SHELBYVILLE, IN 461768846
Phone: (317) 398-0121
Fax: (317) 398-0538
Type: Mailing
2451 INTELLIPLEX DR STE 260
SHELBYVILLE, IN 461768580
Phone: (317) 398-0121
Fax: (317) 398-0538
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 $14.
Total Amount is formed as General ($14) + Research ($0) + Ownership ($0) = $14.
Last reported payment date: 2024-02-07 • Largest payer in this snapshot: Dynavax Technologies Corporation ($14).
Total Amount
$14
General + Research + Ownership
Payments
1
Total payment records
General Amount
$14
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-02-07
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Dynavax Technologies Corporation | $14 |
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: 2011-12-07
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 |
|---|---|---|---|---|
| I20111207000834 | I | Nurse Practitioner | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 46203)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | IN | |
| Nurse Practitioner | IN | |
| Physician Assistant | IL | |
| Mental Health Counselor | IN | |
| Physician Assistant | IN | |
| Nurse Practitioner | IN | |
| Nurse Practitioner | IN | |
| Mental Health Counselor | IN | |
| U R O L O G Y | NH | |
| Nurse Practitioner | IN |
Reviews
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