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

Individual provider Physician Assistant · NPI 1801614656

Mackenzie Lauren Vandervelde, PA-C is a Physician Assistant in Grand Rapids, Michigan. Qualified in 2024, 2 years ago. Practices with Pine Rest Christian Mental Health Services, a 353-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
2
Licensed in
MI
In the registry since
2024
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

300 68th St SE
Grand Rapids, MI 49548-6927
Phone: (616) 455-5000
Fax: (616) 455-5960
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 655 Kenmoor Ave Se Ste 201, Grand Rapids, MI 49546-8604 — (616) 920-0825

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601012783 (MI)

Record details

NPI number1801614656
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 1, 2024
Last updated in NPPESMarch 10, 2026
Certification dateMarch 10, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Pine Rest Christian Mental Health Services — 353 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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