MR. PAWEL MICHAL DUTKIEWICZ (M.D.) – Family Medicine Physician, NPI 1275890097

MR. PAWEL MICHAL DUTKIEWICZ (M.D.) is a healthcare provider. based in South bend, Washington. specializing in FAMILY PRACTICE. They hold the professional credentials M.D.. They hold a License No. MD60752511 (WA). The NPI Number for MR. PAWEL MICHAL DUTKIEWICZ (M.D.) is 1275890097

Main info

Male
17 Years Of Experience
Accepts Medicare Assignment
Name
MR. PAWEL MICHAL DUTKIEWICZ (M.D.)
NPI
1275890097
Phone
(360) 875-5579
Address
826 ALDER ST
Enumeration Date
18 April 2012
Last Update Date
15 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2009 (17 years ago)
PAC ID
5597074153
Group Practice PAC ID
8820986599
Professional Enrollment ID
I20151021002036
Address ID
WA985900500TOPOXXXBOXX201
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience66
Completeness85
Years active:14State licenses:2Digital endpointsOther names

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

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.

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251117002389IFamily PracticeWATBD

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.

Verify on CMS Revalidation Lookup Tool

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

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: 8820986599View full group profile
NameSpecialtyState
Mental Health CounselorWA
Family Practice, Osteopathic Manipulative Medicine, General PracticeWA
Nurse PractitionerND
Nurse PractitionerWA

Reviews

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Frequently asked questions

Can I cross-check MR. PAWEL MICHAL DUTKIEWICZ (M.D.) using NPI 1275890097?
NPI 1275890097 belongs to MR. PAWEL MICHAL DUTKIEWICZ (M.D.); compare other details if you need extra assurance.
Is MR. PAWEL MICHAL DUTKIEWICZ (M.D.) still an active registrant?
MR. PAWEL MICHAL DUTKIEWICZ (M.D.) carries an active NPI according to the public dataset.
What kind of doctor is MR. PAWEL MICHAL DUTKIEWICZ (M.D.)?
MR. PAWEL MICHAL DUTKIEWICZ (M.D.) is associated with Family Medicine Physician in the directory — Clinical services aligned with this taxonomy classification.
Is MR. PAWEL MICHAL DUTKIEWICZ (M.D.) associated with South Bend?
Public fields place MR. PAWEL MICHAL DUTKIEWICZ (M.D.) around South Bend, Washington. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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