MR. DANA ANDRE DEWITT (DO) – Family Medicine Physician, NPI 1124016639

MR. DANA ANDRE DEWITT (DO) is a healthcare provider. based in Jackson, Michigan. specializing in FAMILY PRACTICE. They hold the professional credentials DO. They hold a License No. 5101012782 (MI). The NPI Number for MR. DANA ANDRE DEWITT (DO) is 1124016639

Main info

Male
31 Years Of Experience
Accepts Medicare Assignment
Name
MR. DANA ANDRE DEWITT (DO)
NPI
1124016639
Phone
(517) 783-4664
Address
300 W WASHINGTON AVE
Enumeration Date
10 October 2005
Last Update Date
4 October 2011

Doctor Profile

Medical School Name
MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
9897282800
Graduation Year
1995 (31 years ago)
PAC ID
1355363771
Group Practice PAC ID
3577560846
Professional Enrollment ID
I20120423000732
Address ID
MI487399246HA436XXSTXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

4,418 FAMILY PRACTICE in MI

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Provider Addresses for MR. DANA ANDRE DEWITT (DO)

  • 300, West Washington Avenue, Jackson, Jackson County, Michigan, 49201, United States

    STE 150

    JACKSON, MI 492012180

    Phone: (517) 783-4664

    Fax: (517) 783-4698

    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)

CMS reports 1 Open Payments records for all available years, with a total value of $15.

Total Amount is formed as General ($15) + Research ($0) + Ownership ($0) = $15.

Last reported payment date: 2024-08-21 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($15).

Total Amount

$15

General + Research + Ownership

Payments

1

Total payment records

General Amount

$15

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-21

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
GlaxoSmithKline, LLC.$15
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: 2012-04-23

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
I20120423000732IFamily PracticeMITBD

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 49201)

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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: 3577560846View full group profile
NameSpecialtyState
Nurse PractitionerMI
Nurse PractitionerMI
Nurse PractitionerMI
Internal MedicineMI
Nurse PractitionerMI
Nurse PractitionerMI
Nurse PractitionerMI
Clinical Social WorkerMI
P S Y C H I A T R YMI
Family PracticeMI

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

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Frequently asked questions

What is the registry number for MR. DANA ANDRE DEWITT (DO)?
The registry entry for MR. DANA ANDRE DEWITT (DO) shows NPI 1124016639.
Is MR. DANA ANDRE DEWITT (DO)'s NPI status active today?
Active status means MR. DANA ANDRE DEWITT (DO)'s NPI record is not deactivated in the public file.
How should patients interpret MR. DANA ANDRE DEWITT (DO)'s specialty?
The extract shows Family Medicine Physician for MR. DANA ANDRE DEWITT (DO). Clinical services aligned with this taxonomy classification.
Which community is linked to MR. DANA ANDRE DEWITT (DO)?
MR. DANA ANDRE DEWITT (DO) shows a connection to Jackson, Michigan in registry-derived data.
Who maintains MR. DANA ANDRE DEWITT (DO)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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