ERIC RANDALL DEJONG (AGACNP) – Acute Care Nurse Practitioner, NPI 1629619903

ERIC RANDALL DEJONG (AGACNP) is a healthcare provider. based in Zeeland, Michigan. specializing in NURSE PRACTITIONER. They hold the professional credentials AGACNP. They hold a License No. 4704295254 (MI). The NPI Number for ERIC RANDALL DEJONG (AGACNP) is 1629619903

Main info

Male
7 Years Of Experience
Accepts Medicare Assignment
Name
ERIC RANDALL DEJONG (AGACNP)
NPI
1629619903
Phone
(616) 520-3624
Address
4438 96TH AVE
Enumeration Date
8 October 2019
Last Update Date
14 October 2022

Doctor Profile

Medical School Name
GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
6163915600
Graduation Year
2019 (7 years ago)
PAC ID
1052748001
Group Practice PAC ID
4587568647
Professional Enrollment ID
I20200304000066
Address ID
MI495084600KE4444XSEXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness75
Years active:6State licenses:1Digital endpointsOther names

8,106 NURSE PRACTITIONER in MI

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Provider Addresses for ERIC RANDALL DEJONG (AGACNP)

  • 96th Avenue, Zeeland, Ottawa County, Michigan, 49464, United States

    ZEELAND, MI 494649727

    Phone: (616) 520-3624

    Type: Mailing

  • Borgess Medical Center, 1521, Gull Road, Kalamazoo, Kalamazoo County, Michigan, 49048, United States

    KALAMAZOO, MI 490481640

    Phone: (269) 226-7000

    Type: Location

  • 100 MICHIGAN ST NE # MC845

    GRAND RAPIDS, MI 495032560

    Phone:

    Type: Mailing

  • 602 MICHIGAN AVE STE 102

    HOLLAND, MI 494234918

    Phone: (616) 494-8724

    Type: Location

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: 2020-03-04

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
I20200304000066INurse PractitionerMITBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes288220$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes2014$0
99213Established patient office or other outpatient visit, 20-29 minutes1515$0
View full utilization report →

Insurance plans in this area (ZIP 49464)

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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: 4587568647View full group profile
NameSpecialtyState
Critical Care (Intensivists)IL
Physician AssistantMI
Physician AssistantMI
Physician AssistantMI
-MI
Vascular SurgeryIL
-MI
-MI
A N E S T H E S I O L O G YTX
Clinical Social WorkerMI

Reviews

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Frequently asked questions

Is ERIC RANDALL DEJONG (AGACNP) listed with a National Provider Identifier?
Yes — ERIC RANDALL DEJONG (AGACNP) has NPI 1629619903 on file in the registry.
Active or inactive — what applies to ERIC RANDALL DEJONG (AGACNP)?
You should see ERIC RANDALL DEJONG (AGACNP) as active in CMS-hosted NPPES data.
How would a patient describe ERIC RANDALL DEJONG (AGACNP)'s focus?
For ERIC RANDALL DEJONG (AGACNP), the primary taxonomy reads as Acute Care Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is ERIC RANDALL DEJONG (AGACNP) associated with Zeeland?
Public fields place ERIC RANDALL DEJONG (AGACNP) around Zeeland, Michigan. Always confirm the exact site before visiting.
What does 4 location(s) imply?
4 practice locations appear in the available data.

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