CARL RAY DETTWILER (MD) – Specialist, NPI 1285623819
Specialist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
76 GASTROENTEROLOGY in ID
Provider Addresses for CARL RAY DETTWILER (MD)
2517, 17th Street, Lewiston, Nez Perce County, Idaho, 83501, United States
SUITE B
LEWISTON, ID 835016311
Phone: (208) 743-4373
Fax: (208) 743-3369
Type: Mailing
2517 17TH SREET
SUITE B
LEWISTON, ID 835010001
Phone: (208) 743-4373
Fax: (208) 743-3369
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 10 Open Payments records for all available years, with a total value of $383.
Total Amount is formed as General ($383) + Research ($0) + Ownership ($0) = $383.
Last reported payment date: 2024-11-05 • Largest payer in this snapshot: Janssen Biotech, Inc. ($153).
Total Amount
$383
General + Research + Ownership
Payments
10
Total payment records
General Amount
$383
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-05
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Janssen Biotech, Inc. | $153 |
| Lilly USA, LLC | $103 |
| ABBVIE INC. | $26 |
| Boehringer Ingelheim Pharmaceuticals, Inc. | $25 |
| GENZYME CORPORATION | $23 |
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: 2004-10-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20040907000488 | I | Gastroenterology | ID | TBD |
| I20041013000375 | I | Gastroenterology | WA | 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 |
|---|---|---|---|---|
| G0500 | Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monito | 678 | 536 | $0 |
| 45385 | Removal of polyps or growths of large bowel using an endoscope with mechanical snare | 214 | 210 | $0 |
| 43239 | Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope | 212 | 206 | $0 |
| 43248 | Insertion of guide wire with dilation of esophagus using a flexible endoscope | 163 | 126 | $0 |
| 45380 | Biopsy of large bowel using a flexible endoscope | 150 | 149 | $0 |
Insurance plans in this area (ZIP 83501)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | WA |
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