J K VAN ETTEN
NPI 1114421344
Emergency Medicine - Emergency Medical Services in Cleveland, OH

Q: What is J Van Etten's NPI number?

The NPI number for J Van Etten is 1114421344. It was assigned to this individual provider in the NPPES registry on March 21, 2018.

Q: What is J Van Etten's specialty?

The primary specialty registered for this NPI is Emergency Medicine, specializing in Emergency Medical Services, with taxonomy code 207PE0004X.

Q: When was this NPI record last updated?

The NPPES record for J Van Etten was last updated on December 21, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 21, 2018PECOS EnrolledAccepts Medicare Assignment

2500 METROHEALTH DR, CLEVELAND, OH 44109(216) 778-4486 Get Directions Write a Review

NPPES record last updated: December 21, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 21, 2021, Mar 21, 2018 (2 updates tracked since 2018).

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About J K Van Etten NPPES

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

J K VAN ETTEN (NPI 1114421344) is an individual emergency medical services provider in Cleveland, Ohio, licensed in Washington (MD61136032) and active in the NPI registry since March 2018. She is enrolled in Medicare PECOS, is affiliated with Peacehealth Southwest Medical Center, and maintains a secondary practice location in Vancouver.

NPPES Registry Identity

NPI1114421344

Entity TypeIndividualFemale

Primary Taxonomy207PE0004X

Provider Legal NameJ K VAN ETTEN

Location Address2500 METROHEALTH DRCleveland, OH 44109-1900

Mailing Address3640 Ne Sitka DrCamas, WA 98607-7473

Phone(216) 778-4486

Sole ProprietorNo

Medical School CMSClvlnd Clinic Lerner College Of Med Of Case Wstn Rsv UniversityGraduated 2018

Enumeration DateMarch 21, 2018

Last NPPES UpdateDecember 21, 20212 updates tracked since enumeration

NPPES CertifiedNovember 18, 2021

✔ NPI 1114421344 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEmergency Medicine · Emergency Medical ServicesAllopathic & Osteopathic Physicians

Taxonomy Code207PE0004X

License✔ Licensed in WA · MD61136032

Definition

An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

2500 METROHEALTH DR, Cleveland, OH 44109

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Secondary Practice Location 1

Location 1400 NE Mother Joseph PlVancouver, WA 98664-3200 · Phone (360) 514-2142

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

J K Van Etten 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 ID345597290

PECOS Enrollment IDI20210707003635

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 4

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.

Emergency department visit with high level of medical decision making 99285

An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.

114 services109 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

92 services76 patients

Emergency department visit with moderate level of medical decision making 99284

An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.

50 services46 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

44 services44 patients

Hospital Affiliations CMS Care Compare 2

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

Peacehealth Southwest Medical Center

Acute Care Hospitals · Vancouver, WA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number500050

Location400 NE Mother Joseph PlaceVancouver, WA 98668 · Clark County

Emergency services Birthing friendly

Ocean Beach Hospital

Critical Access Hospitals · Ilwaco, WA

OwnershipGovernment - Hospital District or Authority

CMS Certification Number501314

Location174 First Avenue NorthIlwaco, WA 98624 · Pacific County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 44109 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.72 typical visit price

range $54.34 – $166.65

Typical copayment $21.18 (range $13.58 – $41.66)

Most-billed visit code 99203

Established Patient

$96.44 typical visit price

range $17.10 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

AMIR RAZAVI MD

Internal Medicine