DAKOTA K DEGROOT (PA-C) – Physician Assistant, NPI 1790561546

DAKOTA K DEGROOT (PA-C) is a healthcare provider. based in Granger, Indiana. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 5601011875 (MI). The NPI Number for DAKOTA K DEGROOT (PA-C) is 1790561546

Main info

Female
Sole Proprietor
3 Years Of Experience
Accepts Medicare Assignment
Name
DAKOTA K DEGROOT (PA-C)
NPI
1790561546
Phone
Not provided
Address
3245 HEALTH DR STE 100
Enumeration Date
7 September 2023
Last Update Date
14 February 2024

Doctor Profile

Medical School Name
WESTERN MICHIGAN UN HOMER STRYKER SCHOOL OF MED
Secondary Phone
2317772625232
Graduation Year
2023 (3 years ago)
PAC ID
8527418409
Group Practice PAC ID
4284998154
Professional Enrollment ID
I20231219002957
Address ID
MI494447789NO1450XRDXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

6,069 PHYSICIAN ASSISTANT in MI

Provider Addresses for DAKOTA K DEGROOT (PA-C)

  • 3245 HEALTH DR STE 100

    GRANGER, IN 465301380

    Phone:

    Type: Mailing

  • 3850 GLENKERRY CT

    PORTAGE, MI 490240700

    Phone: (269) 327-7200

    Fax: (269) 327-9272

    Type: Location

  • 12905 76th Ave

    Allendale, MI 494019747

    Phone: (616) 375-5495

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 17 Open Payments records for all available years, with a total value of $403.

Total Amount is formed as General ($403) + Research ($0) + Ownership ($0) = $403.

Last reported payment date: 2024-12-18 • Largest payer in this snapshot: GENZYME CORPORATION ($151).

Total Amount

$403

General + Research + Ownership

Payments

17

Total payment records

General Amount

$403

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-18

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2023-12-19

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20231219002957IPhysician AssistantMITBD

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.

Verify on CMS Revalidation Lookup Tool

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 46530)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4284998154View full group profile
NameSpecialtyState
O T O L A R Y N G O L O G YMI
O T O L A R Y N G O L O G YMI
Qualified AudiologistMI
Physician AssistantMI
Qualified AudiologistMI
Allergy/Immunology, Internal MedicineMI
O T O L A R Y N G O L O G YMI
-MI

Reviews

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Frequently asked questions

What federal number belongs to DAKOTA K DEGROOT (PA-C)?
The federal identifier for DAKOTA K DEGROOT (PA-C) is NPI 1790561546.
Is DAKOTA K DEGROOT (PA-C)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize DAKOTA K DEGROOT (PA-C)'s specialty in plain language?
Clinically, the directory lists DAKOTA K DEGROOT (PA-C) with Physician Assistant. Clinical services aligned with this taxonomy classification.
Does DAKOTA K DEGROOT (PA-C) practice in Indiana?
You will see Granger, Indiana on file for DAKOTA K DEGROOT (PA-C) alongside any extra practice locations.
Is DAKOTA K DEGROOT (PA-C) a real provider?
This page reflects official NPPES data for NPI 1790561546. Always confirm identity and privileges with the practice and licensing boards.

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