DR. KEITH BRYAN DANCKAERT (M.D.) – Dermatology Physician, NPI 1497787659
Dermatology Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. KEITH BRYAN DANCKAERT (M.D.)
330 N Wabash Ave Ste 360
Marion, IN 469522678
Phone: (765) 664-3292
Fax: (765) 662-7560
Type: Location
2246 N Pointe Dr
Warsaw, IN 465829042
Phone: (571) 349-9242
Fax: (572) 349-9243
Type: Location
4020 NEW VISION DR
FORT WAYNE, IN 468451737
Phone: (260) 423-2567
Fax: (260) 420-2415
Type: Location
801, York Street, Manitowoc, Manitowoc County, Wisconsin, 54220, United States
MANITOWOC, WI 542204630
Phone: (920) 663-9016
Fax: (920) 684-1439
Type: Mailing
10620, Corporate Drive, Fort Wayne, Allen County, Indiana, 46825, United States
SUITE A
FORT WAYNE, IN 468451711
Phone: (260) 423-2567
Fax: (260) 420-2415
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2010-12-08
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 |
|---|---|---|---|---|
| I20101208000017 | I | Dermatology | IN | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 46952)
Loading plans...
Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | WI | |
| Physician Assistant | VA | |
| - | VA | |
| D E R M A T O L O G Y | TX | |
| - | WI | |
| D E R M A T O L O G Y | AL | |
| D E R M A T O L O G Y | WI | |
| - | WI | |
| Physician Assistant | NY | |
| D E R M A T O L O G Y | WA |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.