LUCAS DE JONG – Family Medicine Physician, NPI 1164090528

LUCAS DE JONG is a healthcare provider. based in Wichita, Kansas. specializing in GENERAL PRACTICE. They hold a License No. 94-10748 (KS). The NPI Number for LUCAS DE JONG is 1164090528

Main info

Male
5 Years Of Experience
Accepts Medicare Assignment
Name
LUCAS DE JONG
NPI
1164090528
Phone
(316) 293-2665
Address
1010 N KANSAS ST
Enumeration Date
14 June 2021
Last Update Date
14 June 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7122627511
Graduation Year
2021 (5 years ago)
PAC ID
5294139986
Group Practice PAC ID
4183533060
Professional Enrollment ID
I20231108001977
Address ID
IA513014342SP1200XCXXX501
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

53 GENERAL PRACTICE in KS

Provider Addresses for LUCAS DE JONG

  • 1010 N KANSAS ST

    WICHITA, KS 672143124

    Phone: (316) 293-2665

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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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: 2023-11-08

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20231108001977IGeneral PracticeIATBD

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 67214)

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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: 4183533060View full group profile
NameSpecialtyState
Nurse PractitionerIA
Nurse PractitionerIA
Family Practice, Emergency MedicineIA
Medical OncologyMN
Physical Therapist In Private PracticeIA
Family Practice, HospitalistIA
Family PracticeIA
Family PracticeSD
Nurse PractitionerIA
Family PracticeIA

Reviews

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Frequently asked questions

How do I look up LUCAS DE JONG by NPI?
Use NPI 1164090528 when you need to reference LUCAS DE JONG in forms, claims, or directories.
Does this profile mean LUCAS DE JONG is currently active?
Yes — LUCAS DE JONG appears active in the national provider directory.
What field does LUCAS DE JONG work in?
You can think of LUCAS DE JONG as practicing within Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for LUCAS DE JONG?
The page summarizes Wichita, Kansas for LUCAS DE JONG; expand the address list for detail.
How can I contact LUCAS DE JONG?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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