JONATHAN DYKSTRA (MD) – Family Medicine Physician, NPI 1255357935
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,141 FAMILY PRACTICE in WA
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Provider Addresses for JONATHAN DYKSTRA (MD)
1115 SE 164TH AVE DEPT 358
VANCOUVER, WA 986838004
Phone: (360) 735-8100
Fax: (360) 735-3400
Type: Mailing
16811, Southeast McGillivray Boulevard, Vancouver, Clark County, Washington, 98683, United States
VANCOUVER, WA 986833404
Phone: (360) 735-8100
Fax: (360) 735-3400
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $321.
Total Amount is formed as General ($321) + Research ($0) + Ownership ($0) = $321.
Last reported payment date: 2024-11-06 • Largest payer in this snapshot: Urgo Medical North America, LLC ($206).
Total Amount
$321
General + Research + Ownership
Payments
4
Total payment records
General Amount
$321
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Urgo Medical North America, LLC | $206 |
| Integra LifeSciences Corporation | $79 |
| ABBVIE INC. | $36 |
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: 2005-10-12
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 |
|---|---|---|---|---|
| I20051012001022 | I | Family Practice | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 524 | 102 | $0 |
| 11042 | Removal of skin and tissue, 20.0 sq cm or less | 500 | 99 | $0 |
| 97597 | Removal of tissue from wound, 20.0 sq cm or less | 154 | 55 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 142 | 47 | $0 |
| 11045 | Removal of skin and tissue, each additional 20.0 sq cm or less | 107 | 23 | $0 |
Insurance plans in this area (ZIP 98683)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| P S Y C H I A T R Y | WA | |
| Physician Assistant | CA | |
| Family Practice | WA | |
| P A T H O L O G Y | MN | |
| - | WA | |
| - | WA | |
| P S Y C H I A T R Y | WA | |
| Physical Medicine And Rehabilitation | WA | |
| - | VA | |
| Physician Assistant | WA |
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