ERIC JAMES DETTLOFF (PA-C) – Physician Assistant, NPI 1679016638
Physician Assistant
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
6,069 PHYSICIAN ASSISTANT in MI
Provider Addresses for ERIC JAMES DETTLOFF (PA-C)
4100 Lake Dr SE Ste 300
Grand Rapids, MI 495468292
Phone: (616) 267-8860
Type: Location
100 MICHIGAN ST NE # MC845
GRAND RAPIDS, MI 495032560
Phone:
Type: Mailing
7 ATKINSON DR STE 200
LUDINGTON, MI 494311953
Phone: (231) 843-2664
Type: Location
1400 MERCY DR STE 100
MUSKEGON, MI 494441833
Phone: (231) 733-1326
Fax: (231) 733-5212
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $36.
Total Amount is formed as General ($36) + Research ($0) + Ownership ($0) = $36.
Last reported payment date: 2024-07-09 • Largest payer in this snapshot: PFIZER INC. ($21).
Total Amount
$36
General + Research + Ownership
Payments
2
Total payment records
General Amount
$36
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-09
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| PFIZER INC. | $21 |
| Ferring Pharmaceuticals Inc. | $15 |
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: 2018-08-08
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20180808000383 | I | Physician Assistant | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J7318 | Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg | 1,080 | 16 | $0 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 470 | 40 | $0 |
| 20610 | Aspiration and/or injection of fluid from large joint | 74 | 58 | $0 |
| 73564 | X-ray of knee, 4 or more views | 42 | 33 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 36 | 33 | $0 |
Insurance plans in this area (ZIP 49546)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| A N E S T H E S I O L O G Y | MI | |
| Physician Assistant | TX | |
| Physician Assistant | MI | |
| Physician Assistant | MI | |
| Orthopedic Surgery | MI | |
| Orthopedic Surgery | MI | |
| Physician Assistant | MI | |
| Physician Assistant | IL | |
| Orthopedic Surgery | MI | |
| Orthopedic Surgery | MN |
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