FREDERIC J VAN DIS (MD) – Cardiovascular Disease Physician, NPI 1093786261

FREDERIC J VAN DIS (MD) is a healthcare provider. based in Roseburg, Oregon. specializing in Cardiovascular Disease Physician. They hold the professional credentials MD. They hold a License No. MD12356 (OR). The NPI Number for FREDERIC J VAN DIS (MD) is 1093786261

Main info

Male
50 Years Of Experience
Accepts Medicare Assignment
Name
FREDERIC J VAN DIS (MD)
NPI
1093786261
Phone
(541) 677-4319
Address
201 NW MEDICAL LOOP STE 190
Enumeration Date
27 January 2006
Last Update Date
26 May 2020

Doctor Profile

Medical School Name
UNIVERSITY OF MICHIGAN MEDICAL SCHOOL
Secondary Phone
5416774312
Graduation Year
1976 (50 years ago)
PAC ID
9234122995
Group Practice PAC ID
6103982962
Professional Enrollment ID
I20040610001502
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for FREDERIC J VAN DIS (MD)

  • 201 NW MEDICAL LOOP STE 190

    ROSEBURG, OR 974718835

    Phone: (541) 677-4319

    Fax: (541) 677-2294

    Type: Mailing

  • Mercy Drive, Roseburg, Douglas County, Oregon, 97471, United States

    STE. 300

    ROSEBURG, OR 97471

    Phone: (541) 677-1555

    Fax: (541) 677-6543

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 10 Open Payments records for all available years, with a total value of $155.

Total Amount is formed as General ($155) + Research ($0) + Ownership ($0) = $155.

Last reported payment date: 2023-10-18 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($71).

Total Amount

$155

General + Research + Ownership

Payments

10

Total payment records

General Amount

$155

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-10-18

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only1,5651,134$0
99213Established patient office or other outpatient visit, 20-29 minutes11875$0
93000Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report10096$0
99204New patient office or other outpatient visit, 45-59 minutes8484$0
99214Established patient office or other outpatient visit, 30-39 minutes2422$0
View full utilization report →

Insurance plans in this area (ZIP 97471)

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Provider's Procedures

FREDERIC J VAN DIS (MD) performs procedures in Cardiovascular Disease Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
CARDIOVASCULAR DISEASE (CARDIOLOGY)OR93010Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report20201443
CARDIOVASCULAR DISEASE (CARDIOLOGY)OR93280Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report8173

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: 6103982962View full group profile
NameSpecialtyState
N E P H R O L O G YKY
P O D I A T R YOR
Cardiovascular Disease (Cardiology)WA
G A S T R O E N T E R O L O G YOR
Nephrology, Internal MedicineWA
Orthopedic SurgeryCA
General SurgeryOR
General SurgeryOR
Cardiovascular Disease (Cardiology)OR
U R O L O G YOR

Reviews

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Frequently asked questions

What federal number belongs to FREDERIC J VAN DIS (MD)?
The federal identifier for FREDERIC J VAN DIS (MD) is NPI 1093786261.
Does this profile mean FREDERIC J VAN DIS (MD) is currently active?
Yes — FREDERIC J VAN DIS (MD) appears active in the national provider directory.
Does FREDERIC J VAN DIS (MD) list a primary specialty?
If you are matching referrals, note Cardiovascular Disease Physician for FREDERIC J VAN DIS (MD). Clinical services aligned with this taxonomy classification.
What location metadata exists for FREDERIC J VAN DIS (MD)?
The page summarizes Roseburg, Oregon for FREDERIC J VAN DIS (MD); expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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