MARK WILLIAM VAN DYKE (DO) – Addiction Medicine (Internal Medicine) Physician, NPI 1407906613
Addiction Medicine (Internal Medicine) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MARK WILLIAM VAN DYKE (DO)
West 11th Street, Erie, Erie County, Pennsylvania, 16505, United States
2ND FLOOR
ERIE, PA 165011746
Phone: (814) 240-6216
Fax: (814) 240-6219
Type: Mailing
306 W 11TH ST 2ND FL
ERIE, PA 165011705
Phone: (814) 240-6216
Fax: (814) 240-6219
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 8 Open Payments records for all available years, with a total value of $240.
Total Amount is formed as General ($240) + Research ($0) + Ownership ($0) = $240.
Last reported payment date: 2024-11-26 • Largest payer in this snapshot: Braeburn Inc. ($171).
Total Amount
$240
General + Research + Ownership
Payments
8
Total payment records
General Amount
$240
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-26
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Braeburn Inc. | $171 |
| Indivior Inc. | $34 |
| Alkermes, Inc. | $34 |
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: 2009-02-18
PECOS data refreshed: 2026-06-15
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 |
|---|---|---|---|---|
| I20090218000553 | I | Addiction Medicine | PA | 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 16501)
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