J K VAN ETTEN – Emergency Medical Services (Emergency Medicine) Physician, NPI 1114421344
Emergency Medical Services (Emergency Medicine) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,206 EMERGENCY MEDICINE in WA
Provider Addresses for J K VAN ETTEN
3231, West 82nd Street, West Boulevard, Cleveland, Cuyahoga County, Ohio, 44102, United States
CLEVELAND, OH 441024929
Phone: (715) 520-3615
Type: Mailing
400 NE Mother Joseph Pl
Vancouver, WA 986643200
Phone: (360) 514-2142
Type: Location
MetroHealth Medical Center, 2500, Metrohealth Drive, Brooklyn Centre, Cleveland, Cuyahoga County, Ohio, 44109, United States
CLEVELAND, OH 441091900
Phone: (216) 778-4486
Type: Location
3640 NE SITKA DR
CAMAS, WA 986077473
Phone:
Type: Mailing
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: 2021-07-07
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 |
|---|---|---|---|---|
| I20210707003635 | I | Emergency Medicine | WA | 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 |
|---|---|---|---|---|
| 99285 | Emergency department visit with high level of medical decision making | 156 | 149 | $0 |
| 93010 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 123 | 99 | $0 |
| 99284 | Emergency department visit with moderate level of medical decision making | 76 | 73 | $0 |
| 99291 | Critical care, first 30-74 minutes | 71 | 71 | $0 |
Insurance plans in this area (ZIP 44102)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine | MD | |
| Emergency Medicine | WA | |
| - | CA | |
| Emergency Medicine | IL | |
| - | CA | |
| Emergency Medicine | WI | |
| Emergency Medicine | TX | |
| Emergency Medicine | PA | |
| Emergency Medicine | FL | |
| Emergency Medicine | CA |
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