DR. JANE VAN DIS (M.D.) – Obstetrics & Gynecology Physician, NPI 1275699266
Obstetrics & Gynecology Physician
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Profile Insights
NPPES metrics only — not quality of care.
822 OBSTETRICS/GYNECOLOGY in MN
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Provider Addresses for DR. JANE VAN DIS (M.D.)
24th Avenue South, Wenonah, Nokomis, Minneapolis, Hennepin County, Minnesota, 55417, United States
MINNEAPOLIS, MN 554541437
Phone: (612) 273-7111
Type: Mailing
1250 Driving Park Ave
Newark, NY 145131057
Phone: (315) 332-2427
Type: Location
601 ELMWOOD AVE DEPT OBGYN
ROCHESTER, NY 146420001
Phone: (310) 254-7023
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 $1,900.
Total Amount is formed as General ($1,900) + Research ($0) + Ownership ($0) = $1,900.
Last reported payment date: 2023-05-05 • Largest payer in this snapshot: CooperSurgical, Inc. ($1,900).
Total Amount
$1,900
General + Research + Ownership
Payments
2
Total payment records
General Amount
$1,900
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-05-05
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| CooperSurgical, Inc. | $1,900 |
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: 2021-04-21
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 |
|---|---|---|---|---|
| I20210421000118 | I | Obstetrics/Gynecology | NY | 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 55454)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | NY | |
| O B S T E T R I C S/ G Y N E C O L O G Y | NY | |
| O B S T E T R I C S/ G Y N E C O L O G Y | NY | |
| O B S T E T R I C S/ G Y N E C O L O G Y | NY | |
| O B S T E T R I C S/ G Y N E C O L O G Y | NY | |
| O B S T E T R I C S/ G Y N E C O L O G Y | NY | |
| Physician Assistant | NY | |
| Certified Nurse Midwife (Cnm) | NY | |
| Certified Nurse Midwife (Cnm) | NY | |
| - | NY |
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