JAN VON DICKEY (MD) – Family Medicine Physician, NPI 1134153752
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
21,508 INTERNAL MEDICINE in CA
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Provider Addresses for JAN VON DICKEY (MD)
39500;39520, Liberty Street, Fremont, Alameda County, California, 94536, United States
FREMONT, CA 94538
Phone: (510) 252-5887
Type: Location
3917, Ruby Street, Broadway Auto Row, North Oakland, Oakland, Alameda County, California, 94609, United States
OAKLAND, CA 94609
Phone: (510) 658-9459
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 11 Open Payments records for all available years, with a total value of $224.
Total Amount is formed as General ($224) + Research ($0) + Ownership ($0) = $224.
Last reported payment date: 2023-11-27 • Largest payer in this snapshot: Novo Nordisk Inc ($161).
Total Amount
$224
General + Research + Ownership
Payments
11
Total payment records
General Amount
$224
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-11-27
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Novo Nordisk Inc | $161 |
| ABBVIE INC. | $42 |
| Dexcom, Inc. | $21 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2010-07-28
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20100728001185 | I | Internal Medicine | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 98 | 21 | $0 |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 96 | 23 | $0 |
Insurance plans in this area (ZIP 94538)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Registered Dietitian Or Nutrition Professional | CA | |
| Internal Medicine | CA | |
| Pediatric Medicine | CA | |
| Internal Medicine | CA | |
| Internal Medicine | CA | |
| Nurse Practitioner | MO | |
| Internal Medicine | CA | |
| Nurse Practitioner | CA | |
| Clinical Psychologist | CA | |
| Physician Assistant | CA |
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