Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Amy Vandenberg, PA-C

Individual provider Physician Assistant · NPI 1003337601

Amy Vandenberg, PA-C is a Physician Assistant in St Louis Park, Minnesota. Qualified in 2017, 9 years ago. Practices with Park Nicollet Clinic, a 1,773-clinician group, works from 2 locations and accepts Medicare assignment.

Years since qualifying
9
In the registry since
2017
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

3850 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone: (952) 883-1000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4300 Marketpointe Dr Ste 100, Bloomington, MN 55435-5435 — (952) 835-9880

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 12451
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1003337601
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 5, 2017
Last updated in NPPESJuly 21, 2022
Certification dateJune 8, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Park Nicollet Clinic — 1773 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

Other providers in St Louis Park