Dr Jason G De Vries, DPM is a medicare enrolled "Podiatrist" provider in Manitowoc, Wisconsin. He graduated from medical school in 2006 and has 19 years of diverse experience with area of expertise as Podiatry. He is a member of the group practice Baycare Clinic Llp and his current practice location is
1111 Bayshore Dr, Manitowoc, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(920) 682-6376.
Dr Jason G De Vries is licensed to practice in Wisconsin (license number 940) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1609028422.
Healthcare Provider's Profile
| Full Name | Dr Jason G De Vries |
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| Gender | Male |
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| Speciality | Podiatry |
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| Experience | 19 Years |
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| Location | 1111 Bayshore Dr, Manitowoc, Wisconsin |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Jason G De Vries graduated from medical school in 2006
NPI Data:
- NPI Number: 1609028422
- Provider Enumeration Date: 10/13/2008
- Last Update Date: 04/10/2024
Medicare PECOS Information:
- PECOS PAC ID: 8628120706
- Enrollment ID: I20101208000756
Medical Identifiers
Medical identifiers for Dr Jason G De Vries such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1609028422 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 213ES0103X | Podiatrist - Foot & Ankle Surgery | 940-025 (Wisconsin) | Secondary |
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | 940-25 (Wisconsin) | Secondary |
| 213E00000X | Podiatrist | 940 (Wisconsin) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Baycare Clinic Llp | 4385554328 | 183 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Jason G De Vries allows following entities to bill medicare on his behalf.
| Provider Name | Baycare Clinic Llp |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1588609648
PECOS PAC ID: 4385554328
Enrollment ID: O20031105000087 |
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| Provider Name | Ascension Calumet Hospital Inc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1376541748
PECOS PAC ID: 7416948427
Enrollment ID: O20040809000191 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jason G De Vries is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Jason G De Vries, DPM
1035 Kepler Dr,
Green Bay, WI 54311-8320
Ph: (920) 490-9046 | Dr Jason G De Vries, DPM
1111 Bayshore Dr,
Manitowoc, WI 54220-5548
Ph: (920) 682-6376 |
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