MR. PAWEL MICHAL DUTKIEWICZ (M.D.) – Family Medicine Physician, NPI 1275890097
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,141 FAMILY PRACTICE in WA
Provider Addresses for MR. PAWEL MICHAL DUTKIEWICZ (M.D.)
826 ALDER ST
SOUTH BEND, WA 98586
Phone: (360) 875-5579
Fax: (360) 875-5235
Type: Location
PO BOX 269
SOUTH BEND, WA 985860269
Phone: (360) 875-5579
Fax: (334) 566-3768
Type: Mailing
2373 TOKELAND RD BLD E
TOKELAND, WA 98590
Phone: (360) 267-0119
Fax: (360) 267-0417
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 16 Open Payments records for all available years, with a total value of $366.
Total Amount is formed as General ($366) + Research ($0) + Ownership ($0) = $366.
Last reported payment date: 2024-07-25 • Largest payer in this snapshot: Amgen Inc. ($148).
Total Amount
$366
General + Research + Ownership
Payments
16
Total payment records
General Amount
$366
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-25
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Amgen Inc. | $148 |
| PFIZER INC. | $47 |
| Bayer Healthcare Pharmaceuticals Inc. | $39 |
| Lilly USA, LLC | $37 |
| Phathom Pharmaceuticals, Inc. | $37 |
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: 2025-11-17
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 |
|---|---|---|---|---|
| I20251117002389 | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 98586)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Mental Health Counselor | WA | |
| Family Practice, Osteopathic Manipulative Medicine, General Practice | WA | |
| Nurse Practitioner | ND | |
| Nurse Practitioner | WA |
Reviews
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