DR. JACK A DEKKINGA (MD) – MOHS-Micrographic Surgery Physician, NPI 1255365334
MOHS-Micrographic Surgery Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
532 DERMATOLOGY in MI
Provider Addresses for DR. JACK A DEKKINGA (MD)
4175 PARKWAY PLACE DR SW STE 104
GRANDVILLE, MI 494182382
Phone: (616) 257-3344
Fax: (616) 257-1491
Type: Mailing
1673 GEZON PKWY SW
WYOMING, MI 495199519
Phone: (616) 243-3376
Fax: (162) 433-3776
Type: Mailing
100, 44th Street Southwest, Wyoming, Kent County, Michigan, 49548, United States
WYOMING, MI 49519
Phone: (616) 257-1491
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 6 Open Payments records for all available years, with a total value of $426.
Total Amount is formed as General ($426) + Research ($0) + Ownership ($0) = $426.
Last reported payment date: 2024-06-06 • Largest payer in this snapshot: ABBVIE INC. ($362).
Total Amount
$426
General + Research + Ownership
Payments
6
Total payment records
General Amount
$426
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $362 |
| Organon LLC | $25 |
| LEO Pharma Inc. | $21 |
| UCB, Inc. | $19 |
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: 2005-12-21
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 |
|---|---|---|---|---|
| I20051221000349 | I | Dermatology | MI | 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 49418)
Loading plans...
Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DERMATOLOGY | MI | 11101 | Biopsy of each additional growth of skin and/or tissue | 22 | 12 |
| DERMATOLOGY | MI | 14060 | Tissue transfer repair of wound (10 sq centimeters or less) of eyelids, nose, ears, and/or lips | 18 | 17 |
| DERMATOLOGY | MI | 17003 | Destruction of 2-14 skin growths | 385 | 48 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | MI | |
| Physician Assistant | MI | |
| D E R M A T O L O G Y | SD | |
| D E R M A T O L O G Y | MI |
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.