ERIC PITTELKOW (MD) – Plastic Surgery Physician, NPI 1982050340
Plastic Surgery Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
64 PLASTIC AND RECONSTRUCTIVE SURGERY in UT
Provider Addresses for ERIC PITTELKOW (MD)
30 N 1900 E Rm 3B400
Salt Lake City, UT 841320002
Phone: (801) 581-8419
Type: Location
545 BARNHILL DRIVE EMERSON HALL, SUITE 232
INDIANAPOLIS, IN 46202
Phone: (317) 278-0394
Type: Mailing
545 Barnhill Drive Emerson Hall, Suite 232
Indianapolis, IN 46202
Phone: (317) 278-0394
Type: Location
1200 E MICHIGAN AVE
LANSING, MI 489121800
Phone: (517) 364-5388
Type: Mailing
30 N 1900 E RM 3B400
SALT LAKE CITY, UT 841320002
Phone: (801) 581-8419
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 9 Open Payments records for all available years, with a total value of $509.
Total Amount is formed as General ($509) + Research ($0) + Ownership ($0) = $509.
Last reported payment date: 2024-12-20 • Largest payer in this snapshot: Kerecis Limited ($172).
Total Amount
$509
General + Research + Ownership
Payments
9
Total payment records
General Amount
$509
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Kerecis Limited | $172 |
| Stryker Corporation | $139 |
| PolyNovo North America LLC | $80 |
| W. L. Gore & Associates, Inc. | $76 |
| Braintree Laboratories, Inc. | $25 |
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: 2023-07-25
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 |
|---|---|---|---|---|
| I20230725000835 | I | Plastic And Reconstructive Surgery | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 84132)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MI | |
| - | MI | |
| Family Practice | MI | |
| - | MI | |
| P A T H O L O G Y | IL | |
| Nurse Practitioner | MI | |
| Vascular Surgery, General Surgery | MI | |
| Nurse Practitioner | MI | |
| Internal Medicine | MI | |
| Family Practice | MI |
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