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

Individual provider Medical Physician Assistant · NPI 1134514490

Kevin Vandokkumburg, PA-C is a Physician Assistant in Grand Rapids, Michigan. Graduated from Rush Medical College of Rush University in 2015, 11 years ago. Practices with Western Michigan Bone and Joint Surgeons PC, a 5-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
11
Trained at
Rush Medical College of Rush University
Licensed in
MI
In the registry since
2015
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

2144 E Paris Ave SE Ste 240
Grand Rapids, MI 49546-6117
Phone: (616) 949-8945
Fax: (616) 949-1115
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 5601007350 (MI)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 5601007350 (MI)

Record details

NPI number1134514490
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedApril 3, 2015
Last updated in NPPESJune 12, 2023
Certification dateJune 12, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolRUSH MEDICAL COLLEGE OF RUSH UNIVERSITY
Graduated 2015 (11 years in practice)
Group practice Western Michigan Bone And Joint Surgeons Pc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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