Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Jason G De Vries, DPM

Individual provider Podiatrist · NPI 1609028422

Dr. Jason G De Vries, DPM is a Podiatry in Manitowoc, Wisconsin. Qualified in 2006, 20 years ago. Practices with Baycare Clinic LLP, a 196-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
20
Licensed in
WI
In the registry since
2008
Specialties on file
3
What do these letters mean?
DPM — Doctor of Podiatric Medicine
A foot and ankle physician and surgeon.

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Practice location Address checks out

1111 Bayshore Dr
Manitowoc, WI 54220-5548
Phone: (920) 682-6376
Fax: (920) 652-0115
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Podiatrist (primary) Taxonomy 213E00000X · Licence 940 (WI)
Foot & Ankle Surgery Podiatrist Taxonomy 213ES0103X · Licence 940-25 (WI)
Foot & Ankle Surgery Podiatrist Taxonomy 213ES0103X · Licence 940-025 (WI)

Record details

NPI number1609028422
Entity typeIndividual (Type 1)
GenderMale
Credentials DPM
Sole proprietorNo
NPI enumeratedOctober 13, 2008
Last updated in NPPESApril 21, 2026
Certification dateApril 21, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPODIATRY
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Baycare Clinic Llp — 196 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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