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

MS. Cami Jo Kistenfeger, MPAS, PA-C

Individual provider Physician Assistant · NPI 1053620930

MS. Cami Jo Kistenfeger, MPAS, PA-C is a Physician Assistant in South Bend, Indiana. Graduated from At Still Un of Hlth Sciences, Col of Osteo Med, Mesa in 2010, 16 years ago. Practices with Rci (Wrs) LLC, a 330-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Illinois and Indiana.

Years since qualifying
16
Trained at
At Still Un of Hlth Sciences, Col of Osteo Med, Mesa
Licensed in
IL, IN
In the registry since
2010
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

53880 Carmichael Dr
South Bend, IN 46635-1567
Phone: (574) 247-9441
Fax: (745) 247-9442
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 303 S Nappanee St Ste F, Elkhart, IN 46514-2066 — (574) 247-9441
  • 60160 Bodnar Blvd, Mishawaka, IN 46544-9338 — (574) 247-9441
  • 2349 Lake Ave Ste 201, Plymouth, IN 46563-7837 — (574) 247-9441

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 10004288A (IN)
Physician Assistant Taxonomy 363A00000X · Licence 085.003920 (IL)

Record details

NPI number1053620930
Entity typeIndividual (Type 1)
GenderFemale
Credentials MPAS , PA-C
Sole proprietorNo
NPI enumeratedSeptember 27, 2010
Last updated in NPPESSeptember 3, 2024
Certification dateSeptember 3, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolAT STILL UN OF HLTH SCIENCES, COL OF OSTEO MED, MESA
Graduated 2010 (16 years in practice)
Group practice Rci (Wrs) Llc — 330 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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