DR. THOMAS DEREK KOWALIK M.D.
NPI 1023307899
Orthopaedic Surgery - Adult Reconstructive Orthopaedic Surgery in Hillsboro, OR

Q: What is Thomas Kowalik's NPI number?

The NPI number for Thomas Kowalik is 1023307899. It was assigned to this individual provider in the NPPES registry on April 1, 2011.

Q: What is Thomas Kowalik's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Adult Reconstructive Orthopaedic Surgery, with taxonomy code 207XS0114X.

Q: When was this NPI record last updated?

The NPPES record for Thomas Kowalik was last updated on November 30, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 01, 2011PECOS EnrolledAccepts Medicare Assignment

97.83/100

CMS Quality Rating

1200 NE 48TH AVE STE 1100, HILLSBORO, OR 97124(503) 844-8219(503) 844-8234 Get Directions Write a Review

NPPES record last updated: November 30, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 30, 2021, Sep 15, 2016 (2 updates tracked since 2016).

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About Dr. Thomas Derek Kowalik M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. THOMAS DEREK KOWALIK M.D. (NPI 1023307899) is an individual adult reconstructive orthopaedic surgery provider in Hillsboro, Oregon, licensed in Oregon (171470) and active in the NPI registry since April 2011. He is enrolled in Medicare PECOS, is affiliated with Ohsu Hospital And Clinics, and is a graduate of Other (2011).

NPPES Registry Identity

NPI1023307899

Entity TypeIndividualMale

Primary Taxonomy207XS0114X

Provider Legal NameDR. THOMAS DEREK KOWALIKCredential: M.D.

Location Address1200 NE 48TH AVE STE 1100Hillsboro, OR 97124-5062

Mailing Address1200 Ne 48th Ave Ste 1100Hillsboro, OR 97124-5062 · (503) 844-8219 · Fax (503) 844-8234

Phone(503) 844-8219

Fax(503) 844-8234

Sole ProprietorNo

Medical School CMSOtherGraduated 2011

Enumeration DateApril 1, 2011

Last NPPES UpdateNovember 30, 20212 updates tracked since enumeration

NPPES CertifiedNovember 30, 2021

✔ NPI 1023307899 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic Surgery · Adult Reconstructive Orthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207XS0114X

License✔ Licensed in OR · 171470

Definition

Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, adult reconstructive orthopaedic surgeons deal with reconstructive procedures such as joint arthroplasty (i.e., hip and knee), osteotomy, arthroscopy, soft-tissue reconstruction, and a variety of other adult reconstructive surgical procedures.

1200 NE 48TH AVE STE 1100, Hillsboro, OR 97124

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Other Identifiers 1

OtherMD171470OR · License Number

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Kaiser Permanente, Moda Health Plan, Inc. and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Thomas Derek Kowalik M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8224282579

PECOS Enrollment IDI20160831002603

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

X-ray of knee, 3 views 73562

An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.

77 services59 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

70 services67 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

54 services52 patients

Replacement of knee joint, both sides of knee 27447

A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.

47 services44 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

40 services28 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

35 services35 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ohsu Hospital And Clinics

Acute Care Hospitals · Portland, OR

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number380009

Location3181 SW Sam Jackson Park RoadPortland, OR 97239 · Multnomah County

Emergency services Birthing friendly

Hillsboro Medical Center

Acute Care Hospitals · Hillsboro, OR

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number380021

Location335 SE 8th AvenueHillsboro, OR 97123 · Washington County

Emergency services Birthing friendly

Columbia Memorial Hospital

Critical Access Hospitals · Astoria, OR

OwnershipProprietary

CMS Certification Number381320

Location2111 Exchange StreetAstoria, OR 97103 · Clatsop County

Emergency services Birthing friendly

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

97.83/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

80.97

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Walker, folding, wheeled, adjustable or fixed height E0143

DME-Other DME · category DE000N

1 supplier21 claims21 services$47.89 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EVAN KLEIN PA-C

Physician Assistant (Surgical)