DR. JASON BARRETT VAN ITTERSUM (M.D.) – Dermatology Physician, NPI 1750303079
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
532 DERMATOLOGY in MI
Provider Addresses for DR. JASON BARRETT VAN ITTERSUM (M.D.)
650 3 Mile Rd NW Ste 100
Grand Rapids, MI 495441624
Phone: (616) 784-9300
Fax: (616) 784-9308
Type: Location
801 YORK ST
MANITOWOC, WI 542204630
Phone: (920) 663-9008
Fax: (920) 684-1439
Type: Mailing
6225, Prairie Street, Norton Shores, Muskegon County, Michigan, 49444, United States
NORTON SHORES, MI 494447831
Phone: (231) 798-9500
Fax: (231) 798-9533
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $31.
Total Amount is formed as General ($31) + Research ($0) + Ownership ($0) = $31.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: ABBVIE INC. ($31).
Total Amount
$31
General + Research + Ownership
Payments
1
Total payment records
General Amount
$31
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $31 |
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: 2004-03-25
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 |
|---|---|---|---|---|
| I20040325000739 | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 784 | 165 | $0 |
| 96910 | Therapy procedure using ultraviolet radiation with tar or petroleum jelly application | 462 | 16 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 434 | 359 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 346 | 323 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 285 | 270 | $0 |
Insurance plans in this area (ZIP 49544)
Loading plans...
Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | WI | |
| Physician Assistant | VA | |
| - | VA | |
| D E R M A T O L O G Y | TX | |
| - | WI | |
| D E R M A T O L O G Y | AL | |
| D E R M A T O L O G Y | WI | |
| - | WI | |
| Physician Assistant | NY | |
| D E R M A T O L O G Y | WA |
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.