JONATHAN DYKSTRA MD
NPI 1255357935
Family Medicine in Vancouver, WA

Q: What is Jonathan Dykstra's NPI number?

The NPI number for Jonathan Dykstra is 1255357935. It was assigned to this individual provider in the NPPES registry on July 14, 2006.

Q: What is Jonathan Dykstra's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Jonathan Dykstra was last updated on February 29, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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 July 14, 2006PECOS EnrolledAccepts Medicare Assignment

16811 SE MCGILLIVRAY BLVD, VANCOUVER, WA 98683(360) 735-8100(360) 735-3400 Get Directions Write a Review

NPPES record last updated: February 29, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Jonathan Dykstra Md NPPES

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

JONATHAN DYKSTRA MD (NPI 1255357935) is an individual family medicine provider in Vancouver, Washington, licensed in Washington (MD00036202) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Peacehealth Southwest Medical Center, and is a graduate of Wayne State University School Of Medicine (1995).

NPPES Registry Identity

NPI1255357935

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameJONATHAN DYKSTRACredential: MD

Location Address16811 SE MCGILLIVRAY BLVDVancouver, WA 98683-3404

Mailing Address1115 Se 164th Ave Dept 358Vancouver, WA 98683-8004 · (360) 735-8100 · Fax (360) 735-3400

Phone(360) 735-8100

Fax(360) 735-3400

Sole ProprietorNo

Medical School CMSWayne State University School Of MedicineGraduated 1995

Enumeration DateJuly 14, 2006

Last NPPES UpdateFebruary 29, 2016

✔ NPI 1255357935 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in WA · MD00036202

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

16811 SE MCGILLIVRAY BLVD, Vancouver, WA 98683

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Other Identifiers 3

Medicaid8236242WA

Medicare PING8885975WA

Medicare UPING73673

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., PacificSource Health Plans.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

Jonathan Dykstra Md 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 ID8123043718

PECOS Enrollment IDI20051012001022

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 7

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.

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.

482 services84 patients

Removal of skin and tissue, 20.0 sq cm or less 11042

This procedure involves the surgical removal of skin and tissue, up to 20.0 square cm in size. It's often performed to treat conditions like skin cancer or to remove moles, warts, and other skin lesions. The area is numbed and the unwanted tissue is carefully cut out.

472 services81 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.

156 services60 patients

Removal of skin and tissue, each additional 20.0 sq cm or less 11045

This procedure involves the removal of skin and tissue, typically due to disease, injury, or abnormal growth. Each session removes an area of 20.0 square cm or less. It's performed by a trained professional and may require multiple sessions for larger areas.

124 services13 patients

Removal of tissue from wound, 20.0 sq cm or less 97597

This procedure involves the careful removal of damaged or infected tissue from a wound that's 20.0 square cm or less. It's done to promote healing and prevent further infection. The process is carried out under local anesthesia, ensuring minimal discomfort.

63 services31 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

20 services15 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

Legacy Salmon Creek Medical Center

Acute Care Hospitals · Vancouver, WA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number500150

Location2211 NE 139th StreetVancouver, WA 98686 · Clark County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98683 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

$88.29 typical visit price

range $57.27 – $172.80

Typical copayment $22.07 (range $14.31 – $43.20)

Most-billed visit code 99203

Established Patient

$100.78 typical visit price

range $18.56 – $141.11

Typical copayment $25.19 (range $4.64 – $35.27)

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.

Referred Medical Equipment & Supplies CMS DME claims 22

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

Sterile water/saline, 500 ml A4217

DME-Medical/Surgical Supplies · category DA000N

2 suppliers12 claims195 services$3.03 avg. paid by Medicare

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

10 suppliers29 claims80 services$5.86 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

9 suppliers19 claims26 services$0.96 avg. paid by Medicare

Tape, non-waterproof, per 18 square inches A4450

DME-Medical/Surgical Supplies · category DA000N

2 suppliers16 claims824 services$0.09 avg. paid by Medicare

Tape, waterproof, per 18 square inches A4452

DME-Medical/Surgical Supplies · category DA000N

2 suppliers31 claims1,480 services$0.37 avg. paid by Medicare

Tracheostomy, inner cannula A4623

DME-Orthotic Devices · category DF000N

1 supplier11 claims341 services$6.33 avg. paid by Medicare

Tracheal suction catheter, any type other than closed system, each A4624

DME-Other DME · category DE000N

1 supplier12 claims993 services$2.52 avg. paid by Medicare

Oropharyngeal suction catheter, each A4628

DME-Other DME · category DE000N

1 supplier12 claims57 services$3.27 avg. paid by Medicare

Tracheostomy care kit for established tracheostomy A4629

DME-Orthotic Devices · category DF000N

1 supplier12 claims372 services$4.09 avg. paid by Medicare

Collagen dressing, sterile, size 16 sq. in. or less, each A6021

DME-Medical/Surgical Supplies · category DA023N

1 supplier16 claims325 services$20.25 avg. paid by Medicare

Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing A6209

DME-Medical/Surgical Supplies · category DA023N

1 supplier21 claims319 services$7.19 avg. paid by Medicare

Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing A6212

DME-Medical/Surgical Supplies · category DA023N

1 supplier29 claims407 services$9.13 avg. paid by Medicare

Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing A6216

DME-Medical/Surgical Supplies · category DA023N

2 suppliers37 claims2,430 services$0.04 avg. paid by Medicare

Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard A6446

DME-Medical/Surgical Supplies · category DA023N

2 suppliers24 claims1,392 services$0.38 avg. paid by Medicare

Canister, disposable, used with suction pump, each A7000

DME-Other DME · category DE000N

2 suppliers13 claims76 services$6.96 avg. paid by Medicare

Tracheostomy tube collar/holder, each A7526

DME-Orthotic Devices · category DF000N

1 supplier12 claims345 services$3.28 avg. paid by Medicare

Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4035

Other-Enteral and Parenteral · category OB006N

1 supplier12 claims336 services$4.49 avg. paid by Medicare

Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4150

Other-Enteral and Parenteral · category OB006N

1 supplier12 claims5,760 services$0.33 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

1 supplier12 claims12 services$14.87 avg. paid by Medicare

Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for joystick, other control interface or positioning accessory E1028

DME-Wheelchairs · category DD021N

1 supplier14 claims14 services$10.35 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

1 supplier12 claims12 services$63.17 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

1 supplier12 claims12 services$185.34 avg. paid by Medicare

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

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.

SHANNON KRISTINE URBAN ARNP

Nurse Practitioner (Family)