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

Kayla Rene Vanderwall, PA-C

Individual provider Surgical Physician Assistant · NPI 1164840922

Kayla Rene Vanderwall, PA-C is a Physician Assistant in Indianapolis, Indiana. Qualified in 2019, 7 years ago. Practices with Community Physicians of Indiana Inc, a 1,577-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Illinois and Indiana.

Years since qualifying
7
Licensed in
IL, IN
In the registry since
2014
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

7430 N Shadeland Ave Ste 200
Indianapolis, IN 46250-2036
Phone: (317) 621-0668
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 1200 S York St Ste 3280, Elmhurst, IL 60126-5638 — (630) 646-6020
  • 7979 N Shadeland Ave Ste 310, Indianapolis, IN 46250-2042 — (317) 621-0668
  • 231 Noordewier Hall, Grand Rapids, MI 49546-4417 — (219) 743-9368

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X (IN)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 085007328 (IL)

Record details

NPI number1164840922
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMarch 30, 2014
Last updated in NPPESSeptember 1, 2022
Certification dateSeptember 1, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Community Physicians Of Indiana Inc — 1577 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations10 on file with Medicare

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