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

Kelly Rae Vandermuss, PA-C

Individual provider Physician Assistant · NPI 1760042923

Kelly Rae Vandermuss, PA-C is a Physician Assistant in De Pere, Wisconsin. Qualified in 2009, 17 years ago. Practices with St Vincent Hospital-Hospital Sisters-Third Order of St Francis, a 594-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
17
Licensed in
WI
In the registry since
2019
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

1381 Brayden Ln
De Pere, WI 54115-9249
Phone: (920) 664-3734
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 4704-23 (WI)

Record details

NPI number1760042923
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 19, 2019
Last updated in NPPESDecember 5, 2019

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice St Vincent Hospital-Hospital Sisters-Third Order Of St Francis — 594 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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